Fractionated stereotactic radiotherapy as a primary therapy for cerebral arteriovenous malformation
JEONGSHIM LEE,
Korea Republic of
PO-1157
Abstract
Fractionated stereotactic radiotherapy as a primary therapy for cerebral arteriovenous malformation
Authors: JEONGSHIM LEE1, Woo Chul Kim1, Hun Jung Kim1, Hyun Joo Kim2, Hyun Sun Park3
1Inha University School of Medicine, Department of Radiation Oncology, Incheon, Korea Republic of; 2Gacheon University School of Medicine, Department of Radiation Oncology, Incheon, Korea Republic of; 3Inha University School of Medicine, Department of Neurosurgery, Incheon, Korea Republic of
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Purpose or Objective
To explore the therapeutic outcomes of Cyberknife fractionated stereotactic radiotherapy (CKFRT) for patients with cerebral arteriovenous malformations (AVM).
Material and Methods
Between January 2008 and October 2011, 45 patients underwent CKFRT for cerebral AVMs as a primary treatment. The delineation of AVM targets included AVM nidus. The mean target volume was 4.07 cm³ and 9 lesions (20%) were larger than 10.0 cm³. CKFRT was delivered in median three fractions (range, 2~5 fractions). The mean marginal dose was 24 Gy (range, 20-35 Gy). Generally, AVM obliteration following CKFRT was confirmed by magnetic resonance imaging or angiography.
Results
During a mean follow-up of 46 (5-147) months, complete obliteration and partial obliteration of AVM after CKFRT were obtained in 23 (51.1%) and 13 (28.9%) patients, respectively. Median time to complete obliteration was 39 (15-63) months. The cumulative probability of complete obliteration rate at 3 years was 47%. Complete obliteration rate of AVM was associated with Radiosurgery-based AVM score, which was consisted of AVM volume, patients age, and AVM location. One (2.2%) patient had hemorrhage during the follow-up period. Continuous neurological deficit after CKFRT was observed in 11(24.4%) patients.
Conclusion
CKFRT is an effective primary treatment for patients with cerebral AVMs with a low hemorrhage risk.