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首页> 外文期刊>Neurosurgical focus >Volume-staged versus dose-staged radiosurgery outcomes for large intracranial arteriovenous malformations
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Volume-staged versus dose-staged radiosurgery outcomes for large intracranial arteriovenous malformations

机译：颅内动静脉畸形的分阶段与剂量分阶段放射外科治疗结局

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Object: The aim in this paper was to compare the outcomes of dose-staged and volume-staged stereotactic radiosurgery (SRS) in the treatment of large ( 10 cm3) arteriovenous malformations (AVMs). Methods: A systematic literature review was performed using PubMed. Studies written in the English language with at least 5 patients harboring large ( 10 cm3) AVMs treated with dose- or volume-staged SRS that reported posttreatment outcomes data were selected for review. Demographic information, radiosurgical treatment parameters, and post-SRS outcomes and complications were analyzed for each of these studies. Results: The mean complete obliteration rates for the dose- and volume-staged groups were 22.8% and 47.5%, respectively. Complete obliteration was demonstrated in 30 of 161 (18.6%) and 59 of 120 (49.2%) patients in the dose- and volume-staged groups, respectively. The mean rates of symptomatic radiation-induced changes were 13.5% and 13.6% in dose- and volume-staged groups, respectively. The mean rates of cumulative post-SRS latency period hemorrhage were 12.3% and 17.8% in the dose- and volume-staged groups, respectively. The mean rates of post-SRS mortality were 3.2% and 4.6% in dose- and volume-staged groups, respectively. Conclusions: Volume-staged SRS affords higher obliteration rates and similar complication rates compared with dose-staged SRS. Thus, volume-staged SRS may be a superior approach for large AVMs that are not amenable to single-session SRS. Staged radiosurgery should be considered as an efficacious component of multimodality AVM management.
机译：目的：本文的目的是比较剂量阶段和体积阶段立体定向放射外科手术（SRS）治疗大（> 10 cm3）动静脉畸形（AVM）的结果。方法：使用PubMed进行系统的文献综述。选择以英语撰写的研究，至少有5名患者接受了剂量（或体积）分期的SRS治疗的大（> 10 cm3）大AVM，并报告了治疗后的结果数据，以进行回顾。对这些研究中的每一项都分析了人口统计学信息，放射外科治疗参数以及SRS后的结果和并发症。结果：剂量阶段和体积阶段的平均完全闭塞率分别为22.8％和47.5％。在剂量和剂量分期组中，分别有161名患者中的30名（18.6％）和120名患者中的59名（49.2％）表现出完全闭塞。在剂量和体积分阶段的组中，有症状辐射引起的变化的平均比率分别为13.5％和13.6％。在剂量和体积分阶段的组中，SRS潜伏期后累积出血的平均发生率分别为12.3％和17.8％。在剂量和体积分阶段的组中，SRS后的平均死亡率分别为3.2％和4.6％。结论：与剂量分期的SRS相比，分阶段的SRS具有更高的闭塞率和相似的并发症发生率。因此，对于不适合单会话SRS的大型AVM，卷分段SRS可能是一种更好的方法。分阶段放射外科应被视为多模态AVM管理的有效组成部分。

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