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首页> 外文期刊>Radiotherapy and oncology: Journal of the European Society for Therapeutic Radiology and Oncology >Clinical outcome after repeated radiosurgery for brain arteriovenous malformations.
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Clinical outcome after repeated radiosurgery for brain arteriovenous malformations.

机译：反复进行脑动静脉畸形手术后的临床结果。

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INTRODUCTION: We assessed the clinical and radiological outcome after repeated radiosurgery for brain arteriovenous malformations (bAVMs) after failure of initial radiosurgery. MATERIALS AND METHODS: Fifteen patients underwent repeated radiosurgery. The mean bAVM volume at first radiosurgery (S1) was 4.6 +/- 4.3 ml and that at second radiosurgery (S2) was 2.1 +/- 2.5 ml. The median marginal dose was 18 Gy at S1, and 21 Gy at S2. Modified Rankin Scale (MRS) score was determined in all patients at last follow-up (FU). RESULTS: Complete obliteration was reached in nine patients (60%). Median time to obliteration was 50 months after S2. An excellent outcome (no new neurologic deficiencies, complete obliteration) was reached in seven patients (47%). Eleven patients (73%) showed a MRS1. Radiation-induced complications occurred in 20%, of which 13% occurred after S2. Radiological complications included cyst formation (n = 1), radiation-related edema (n = 4), and radiation necrosis (n = 1), resulting in an increasing mean MRS of 0.5 at S1, 0.6 at S2, to 0.8 at FU. No (re-)bleedings were encountered during 137-patient years at risk. DISCUSSION: Repeated radiosurgery is a viable option for the treatment of small remnant bAVMs. We report 20% permanent radiation-induced complications. Such complications were mainly seen in relatively large, and therefore difficult to treat, bAVMs.
机译：简介：我们评估了在初次放射手术失败后反复进行放射外科手术后脑动静脉畸形（bAVM）的临床和放射学结果。材料与方法：15例患者接受了反复的放射外科手术。第一次放射外科手术（S1）的平均bAVM体积为4.6 +/- 4.3毫升，第二次放射外科手术（S2）的平均bAVM体积为2.1 +/- 2.5毫升。中位边缘剂量在S1为18 Gy，在S2为21 Gy。在最后一次随访（FU）时确定所有患者的改良Rankin量表（MRS）评分。结果：9名患者（60％）达到完全闭塞。闭塞的中位时间为S2后50个月。 7名患者（47％）达到了极好的结果（无新的神经系统缺陷，完全闭塞）。 11名患者（73％）显示MRS1。放射诱发的并发症发生率为20％，其中13％发生在S2之后。放射学并发症包括囊肿形成（n = 1），与放射有关的水肿（n = 4）和放射坏死（n = 1），导致平均MRS在S1为0.5，在S2为0.6，在FU为0.8。在137位患者的风险年中，未发生（再）出血。讨论：重复放射外科手术是治疗小残留bAVM的可行选择。我们报告了20％的永久性辐射诱发并发症。这种并发症主要出现在相对较大的bAVM中，因此很难治疗。

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