Background: The effectiveness and risk of gamma knife surgery (GKS) in the management of partially embolized cerebral arteriovenous malformations (AVMs) remain to be elucidated.
Objective: To evaluate the long-term imaging and clinical outcomes of GKS in AVM patients who had undergone previous partial embolization and compare the results with patients treated with GKS alone.
Methods: A total of 215 embolized AVMs were analyzed. The mean patient age was 32.9 years. The mean volume of the nidus was 4.6 mL (range, 0.1-29.4 mL), and the mean prescription dose was 19.6 Gy (range, 4-28 Gy). This group was compared with 729 nonembolized AVMs.
Results: After embolization and GKS, angiographically confirmed total obliteration of the AVMs was significantly lower (33%) compared with patients in whom GKS was used alone (60.9%; P < .001). However, the mean nidus size was larger and the Spetzler-Martin grade was higher for the embolized AVMs compared with the nonembolized AVMs. Radiation-induced changes occurred more often in the embolized (43.4%) than the nonembolized (33.4%) AVMs (P = .028). Permanent neurological deficits associated with radiation-induced changes occurred in 2.7% of the embolized compared with 1.3% of the nonembolized patients (P = .14).
Conclusion: In our retrospective and historical series, the long-term results suggest that the obliteration rate is significantly lower in embolized AVMs compared with nonembolized AVMs, also because of the fact that the combined treatment is applied to higher grade AVMs; the percentage of grade III-V AVMs was 58.6% and 48.8% for nonembolized AVMs.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1227/NEU.0b013e3182720280 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predicting local control of brain metastases after stereotactic radiotherapy with clinical, radiomics and deep learning features.
Radiat Oncol
December 2024
Department of Cognitive Neuropsychology, Tilburg University, Tilburg, The Netherlands.
Background And Purpose: Timely identification of local failure after stereotactic radiotherapy for brain metastases allows for treatment modifications, potentially improving outcomes. While previous studies showed that adding radiomics or Deep Learning (DL) features to clinical features increased Local Control (LC) prediction accuracy, their combined potential to predict LC remains unexplored. We examined whether a model using a combination of radiomics, DL and clinical features achieves better accuracy than models using only a subset of these features.
View Article and Find Full Text PDFReduced irradiation exposure areas enhanced anti-tumor effect by inducing DNA damage and preserving lymphocytes.
Mol Med
December 2024
State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing, 100871, China.
Background: Partial stereotactic body radiation therapy (SBRT) targeting hypoxic regions of large tumors (SBRT-PATHY) has been shown to enhance the efficacy of tumor radiotherapy by harnessing the radiation-induced immune response. This approach suggests that reducing the irradiation target volume not only achieves effective anti-tumor effects but also minimizes damage to surrounding normal tissues. In this study, we evaluated the antitumor efficacy of reduced-tumour-area radiotherapy (RTRT) , and explored the relationship between tumor control and immune preservation and the molecular mechanisms underlying of them.
View Article and Find Full Text PDFDevelopment of respiratory motion-resolved hepatobiliary phase cine-magnetic resonance imaging for stereotactic body radiotherapy in liver tumor.
Sci Rep
December 2024
Department of Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
Cine-magnetic resonance imaging (MRI) has been used to track respiratory-induced motion of the liver and tumor and assist in the accurate delineation of tumor volume. Recent developments in compressed sensitivity encoding (SENSE; CS) have accelerated temporal resolution while maintaining contrast resolution. This study aimed to develop and assess hepatobiliary phase (HBP) cine-MRI scans using CS.
View Article and Find Full Text PDFInvestigating the effects of stereotactic body radiation therapy on pancreatic tumor hypoxia and microvasculature in an orthotopic mouse model using intravital fluorescence microscopy.
Sci Rep
December 2024
Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
Despite decades of improvements in cytotoxic therapy, the current standard of care for locally advanced pancreatic cancer (LAPC) provides, on average, only a few months of survival benefit. Stereotactic Body Radiation Therapy (SBRT), a technique that accurately delivers high doses of radiation to tumors in fewer fractions, has emerged as a promising therapy to improve local control of LAPC; however, its effects on the tumor microenvironment and hypoxia remain poorly understood. To explore how SBRT affects pancreatic tumors, we combined an orthotopic mouse model of pancreatic cancer with an intravital microscopy platform to visualize changes to the in vivo tumor microenvironment in real-time.
View Article and Find Full Text PDFImmunotherapy or targeted therapy with or without stereotactic radiosurgery for patients with brain metastases from melanoma or non-small cell lung cancer - The ETOP 19-21 USZ-STRIKE study.
Lung Cancer
December 2024
Coordinating Center, ETOP IBCSG Partners Foundation, Bern, Switzerland.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!