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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Repeated linac-based radiosurgery in high-grade cerebral arteriovenous-malformations (AVM) Spetzler-Martin grade III to IV previously treated with radiosurgery.
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Repeated linac-based radiosurgery in high-grade cerebral arteriovenous-malformations (AVM) Spetzler-Martin grade III to IV previously treated with radiosurgery.

机译：在高级脑动静脉畸形（AVM）Spetzler-Martin以前经放射外科治疗的III至IV级中，反复进行基于直线加速器的放射外科手术。

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BACKGROUND: Aim was to access outcome and toxicity of repeated linac-based radiosurgery in incompletely obliterated cerebral AVM. PATIENTS AND METHODS: Between 1998 and 2008, 11 patients were treated with repeated radiosurgery. The median dose to the 80%-isodose was 15 Gy (range, 12-18 Gy). During initial radiosurgery the median dose was 18 Gy (range, 9-22 Gy). RESULTS: The median time interval between initial radiosurgery and re-treatment was 9 years (range, 4-16 years). The median follow-up was 26 months (range, 2-115 months). Treatment response was seen in 8 patients (89%). Complete (partial) obliteration was achieved in 5 (3) patients (56%, 33%, respectively).The median time to complete obliteration was 26 months (range, 5-45 months). Pre-existing neurological symptoms improved in 2 patients (18%), were stable in 7 patients (64%) and worsened in 2 patients (18%). Prevalence of intracranial hemorrhage was 9% (1/11). Post-re-treatment intracranial hemorrhage rate was 2.7% (1/38 years at risk). During follow-up, no secondary malignancies or toxicity>grade III were observed. CONCLUSION: Repeated linac-based radiosurgery in incompletely obliterated cerebral AVM is an effective treatment option with a high rate of treatment response and an acceptable risk for side effects. Marginal doses above 15 Gy might further improve the rate of complete obliterations.
机译：摘要背景：目的是研究在不完全闭塞的脑AVM中反复进行基于直线加速器的放射外科手术的结果和毒性。患者与方法：1998年至2008年，有11例患者接受了反复放射外科手术治疗。 80％等剂量的中位剂量为15 Gy（范围12-18 Gy）。在最初的放射外科手术期间，中位剂量为18 Gy（范围9-22 Gy）。结果：初始放射外科手术和再治疗之间的中位时间间隔为9年（范围4-16年）。中位随访时间为26个月（范围2-115个月）。 8例（89％）出现治疗反应。 5（3）例患者完全闭塞（部分）（分别为56％和33％）。中度完全闭塞时间为26个月（范围：5-45个月）。已有的神经系统症状改善2例（18％），稳定7例（64％），恶化2例（18％）。颅内出血的患病率为9％（1/11）。再治疗后颅内出血率为2.7％（处于危险期的1/38年）。在随访期间，未观察到继发性恶性肿瘤或毒性> III级。结论：在不完全闭塞的脑AVM中反复进行基于直线加速器的放射外科手术是一种有效的治疗选择，具有较高的治疗反应率和可接受的副作用风险。超过15 Gy的边缘剂量可能会进一步提高完全闭塞的速度。

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