Fractionated stereotactic radiosurgery in treating the complex intracranial arteriovenous malformations

Peng Wei Hsu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

Abstract

Background: The aim of this study was to examine the efficacy and safety of treating large or eloquently located intracranial arteriovenous malformations (AVMs) with fractionated stereotactic radiosurgery (FSRS). Materials and Methods: Eighteen patients with AVM treated with FSRS between March 2006 and August 2018 were retrospectively evaluated. The nidus obliteration, volume reduction, rate of rebleeding, newly onset neurological deficit, and signal change in magnetic resonance imaging (MRI) were evaluated. Results: With a median follow-up of 88 months (range: 24-154), 6 of the 18 lesions (33.3%) had a complete obliteration. All obliteration occurred in patients received the total treatment dose of 21 Gy (6 of 9 patients, 66.7%). The median time to complete obliteration was 38 months (range: 12-53). The mean volume reduction after FSRS in the 25 Gy group was 30.2% ± 20.9% and that in the 21 Gy group was 87.7% ± 24.2%. During the follow-up period, 4 of 18 (22.2%) lesions revealed T2 signal change in the MRI. No FSRS-related complication was noted clinically or radiologically. Conclusion: According to the present results, FSRS could be an effective and safe treatment alternative for complicated AVMs. Delayed toxicity after treatment is not noticed in the current study, but long-term follow-up is required. A higher dose in total and each fraction is likely needed when treating larger lesions.

Original languageEnglish
Pages (from-to)45-51
Number of pages7
JournalZhonghua Minguo wai ke yi xue hui za zhi
Volume54
Issue number2
DOIs
StatePublished - 01 03 2021

Bibliographical note

Publisher Copyright:
© 2021 Formosan Journal of Surgery | Published by Wolters Kluwer-Medknow.

Keywords

  • Arteriovenous malformation
  • Eloquently located
  • Fractionated
  • Large
  • Radiosurgery

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