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Titolo:
A multi-institutional analysis of complication outcomes after arteriovenous malformation radiosurgery
Autore:
Flickinger, JC; Kondziolka, D; Lunsford, LD; Pollock, BE; Yamamoto, M; Gorman, DA; Schomberg, PJ; Sneed, P; Larson, D; Smith, V; McDermott, MW; Miyawaki, L; Chilton, J; Morantz, RA; Young, B; Jokura, H; Liscak, R;
Indirizzi:
Univ Pittsburgh, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USAUniv Pittsburgh, Pittsburgh, PA USA Mayo Clin, Rochester, MN USA Mayo Clin Rochester MN USAMayo Clin, Rochester, MN USA Tokyo Womens Med Coll, Tokyo 162, Japan Tokyo Womens Med Coll Tokyo Japan 162 Womens Med Coll, Tokyo 162, Japan Univ Calif San Francisco, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Midwest Gamma Knife Ctr, Kansas City, MO USA Midwest Gamma Knife Ctr Kansas City MO USA nife Ctr, Kansas City, MO USA Univ Kentucky, Louisville, KY USA Univ Kentucky Louisville KY USAUniv Kentucky, Louisville, KY USA Tohoku Univ, Sendai, Miyagi 980, Japan Tohoku Univ Sendai Miyagi Japan 980 ohoku Univ, Sendai, Miyagi 980, Japan Hosp Na Homolce, Prague, Czech Republic Hosp Na Homolce Prague Czech Republic a Homolce, Prague, Czech Republic
Titolo Testata:
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
fascicolo: 1, volume: 44, anno: 1999,
pagine: 67 - 74
SICI:
0360-3016(19990401)44:1<67:AMAOCO>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
GAMMA-KNIFE RADIOSURGERY; STEREOTAXIC RADIOSURGERY; MULTIVARIATE-ANALYSIS; IMAGING CHANGES; BRAIN; THERAPY; RISK;
Keywords:
radiosurgery; stereotactic surgery; arteriovenous malformation; complications; radiation injury;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Flickinger, JC Joint Ctr Radiat Oncol, 200 Lothrop St, Pittsburgh, PA 15213 USA Joint Ctr Radiat Oncol 200 Lothrop St Pittsburgh PA USA 15213
Citazione:
J.C. Flickinger et al., "A multi-institutional analysis of complication outcomes after arteriovenous malformation radiosurgery", INT J RAD O, 44(1), 1999, pp. 67-74

Abstract

Purpose: To better understand radiation complications of arteriovenous malformation (AVM) radiosurgery and factors affecting their resolution. Methods and Materials: AVM patients (102/1255) who developed neurological sequelae after radiosurgery were studied. The median AVM marginal dose (D-min) was 19 Gy (range: 10-35). The median volume was 5.7 cc (range: 0.26-143). Median follow-up was 34 months (range: 9-140). Results: Complications consisted of 80/102 patients with evidence of radiation injury to the brain parenchyma (7 also with cranial nerve deficits, 12also with seizures, 5 with cyst formation), 12/102 patients with isolated cranial neuropathies, and 10/102 patients with only new or worsened seizures. Severity was classified as minimal in 39 patients, mild in 40, disablingin 21, and fatal in 2 patients. Symptoms resolved completely in 42 patients for an actuarial resolution rate of 54% +/- 7% at 3 years post-onset. Multivariate analysis identified significantly greater symptom resolution in patients with no prior history of hemorrhage (p = 0.01, 66% vs. 41%), and inpatients with symptoms of minimal severity: headache or seizure as the only sequelae of radiosurgery (p < 0.0001, 88% vs. 34%). Conclusion: Late sequelae of radiosurgery manifest in varied ways. Furtherlong-term studies of these problems are needed that take into account symptom severity and prior hemorrhage history. (C) 1999 Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/08/20 alle ore 07:11:24