التفاصيل البيبلوغرافية
| العنوان: |
Stereotactic radiosurgery at a low marginal dose for the treatment of pediatric arteriovenous malformations: obliteration, complications, and functional outcomes. |
| المؤلفون: |
Potts, Matthew B, Sheth, Sunil A, Louie, Jonathan, Smyth, Matthew D, Sneed, Penny K, McDermott, Michael W, Lawton, Michael T, Young, William L, Hetts, Steven W, Fullerton, Heather J, Gupta, Nalin |
| المصدر: |
Journal of Neurosurgery Pediatrics, vol 14, iss 1 |
| بيانات النشر: |
eScholarship, University of California |
| سنة النشر: |
2014 |
| المجموعة: |
University of California: eScholarship |
| مصطلحات موضوعية: |
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Congenital Structural Anomalies, Pediatric, Neurosciences, Brain Disorders, Clinical Research, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Adolescent, Cerebral Angiography, Child, Preschool, Female, Humans, Infant, Intracranial Arteriovenous Malformations, Male, Radiation Dosage, Radiosurgery, Retrospective Studies, Treatment Outcome, arteriovenous malformation, stereotactic radiosurgery, vascular disorders, AVM = arteriovenous malformation, SRS = stereotactic radiosurgery, UCSF = University of California, San Francisco |
| جغرافية الموضوع: |
1 - 11 |
| الوصف: |
UnlabelledOBJECT.: Stereotactic radiosurgery (SRS) is an established treatment modality for brain arteriovenous malformations (AVMs) in children, but the optimal treatment parameters and associated treatment-related complications are not fully understood. The authors present their single-institution experience of using SRS, at a relatively low marginal dose, to treat AVMs in children for nearly 20 years; they report angiographic outcomes, posttreatment hemorrhage rates, adverse treatment-related events, and functional outcomes.MethodsThe authors conducted a retrospective review of 2 cohorts of children (18 years of age or younger) with AVMs treated from 1991 to 1998 and from 2000 to 2010.ResultsA total of 80 patients with follow-up data after SRS were identified. Mean age at SRS was 12.7 years, and 56% of patients had hemorrhage at the time of presentation. Median target volume was 3.1 cm(3) (range 0.09-62.3 cm(3)), and median prescription marginal dose used was 17.5 Gy (range 12-20 Gy). Angiograms acquired 3 years after treatment were available for 47% of patients; AVM obliteration was achieved in 52% of patients who received a dose of 18-20 Gy and in 16% who received less than 18 Gy. At 5 years after SRS, the cumulative incidence of hemorrhage was 25% (95% CI 16%-37%). No permanent neurological deficits occurred in patients who did not experience posttreatment hemorrhage. Overall, good functional outcomes (modified Rankin Scale Scores 0-2) were observed for 78% of patients; for 66% of patients, functional status improved or remained the same as before treatment.ConclusionsA low marginal dose minimizes SRS-related neurological deficits but leads to low rates of obliteration and high rates of hemorrhage. To maximize AVM obliteration and minimize posttreatment hemorrhage, the authors recommend a prescription marginal dose of 18 Gy or more. In addition, SRS-related symptoms such as headache and seizures should be considered when discussing risks and benefits of SRS for treating AVMs in children. |
| نوع الوثيقة: |
article in journal/newspaper |
| وصف الملف: |
application/pdf |
| اللغة: |
unknown |
| العلاقة: |
qt4wb3k1kp; https://escholarship.org/uc/item/4wb3k1kpTest |
| الإتاحة: |
https://escholarship.org/uc/item/4wb3k1kpTest |
| حقوق: |
public |
| رقم الانضمام: |
edsbas.B6818533 |
| قاعدة البيانات: |
BASE |
