[Radiosurgery of cerebral arteriovenous malformations: a prescription algorithm]

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Date publication

janvier 2009

Auteurs

Membres identifiés du Cancéropôle Est :
Dr BERNIER-CHASTAGNER Valérie, Dr DESANDES Emmanuel, Pr PEIFFERT Didier


Tous les auteurs :
Blanchard N, Bernier V, Anxionnat R, Picard L, Marchal C, Buchheit I, Metayer C, Desandes E, Peiffert D

Résumé

PURPOSE: To study prognostic factors of obliteration and risk factors of brain radiation necrosis in order to propose an algorithm for radiosurgery prescription for cerebral arteriovenous malformations (cAVM). MATERIAL AND METHODS: One hundred and seventy-nine patients were analysed. Radiosurgery delivered 6 or 10 MV X-rays by arc therapy in 84% of cases, or by fixed field in 16% of cases using two different micro-multileaf collimators (micro-MLC). Follow-up consisted of screening radiation necrosis by MRI every 6 months, and assessing local control by arteriography every 2 years. Obliteration was defined as at least 95% reduction of cAVM volume. Cox proportional hazard model was used to evaluate the local control and the appearance of radiation necrosis over time. RESULTS: Local control rate was 82.7% with the mean follow-up of 3.1 years (0.5-11). Significant prognostic factors were: simple nidus (RR=2.8, p

Référence

Cancer Radiother. 2009 Jan;13(1):1-10