Document Detail


Stereotactic radiosurgery of cerebral arteriovenous malformations with a multileaf collimator and a single isocenter.
MedLine Citation:
PMID:  10917355     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To prospectively demonstrate the safety and efficacy of stereotactic radiosurgery for arteriovenous malformations (AVMs) of the brain with a linear accelerator fitted with a multileaf collimator. METHODS: A novel radiosurgery system was developed at the University of Michigan Medical Center with a standard multileaf collimator and a computer-controlled radiotherapy system. Data were accumulated prospectively on all patients undergoing treatment with this system since treatment began in 1995. RESULTS: Thirty-six patients with 37 AVMs have undergone treatment to date. At more than 3 years since treatment, 15 of 16 AVMs with a volume of less than 10 cc were proven to be obliterated by angiography or magnetic resonance imaging, and one was considered a treatment failure. At more than 24 months since therapy, all four AVMs with a volume of 10 to 25 cc were obliterated. Four patients with AVMs with a volume of more than 25 cc have undergone staged therapy, treating the entire volume to 10 Gy twice, but none has been followed long enough to demonstrate a final outcome. There were four transient and no permanent complications. CONCLUSION: Our early data indicate that stereotactic radiosurgery of cerebral AVMs with a linear accelerator and a multileaf collimator is safe and effective. Large AVMs may be especially suitable for this mode of therapy. Staged treatment of very large AVMs seems to be a promising addition to standard treatment, but longer follow-up is necessary to confirm that complete obliteration can be achieved.
Authors:
D A Ross; H M Sandler; J M Balter; J A Hayman; J Deveikis; D L Auer
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  47     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2001-01-03     Completed Date:  2001-01-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  123-8; discussion 128-30     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Michigan, Ann Arbor, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Child
Humans
Intracranial Arteriovenous Malformations / surgery*
Middle Aged
Prospective Studies
Radiosurgery / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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