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Clinical outcomes following stereotactic radiosurgery for cerebral cavernous malformations of the basal ganglia and thalamus
R. Singh, C. Dumot, G. Mantziaris, S. Dayawansa, Z. Xu, S. Pikis, S. Peker, Y. Samanci, GD. Ardor, AM. Nabeel, WA. Reda, SR. Tawadros, K. Abdel Karim, AMN. El-Shehaby, RM. Emad Eldin, D. Sheehan, K. Sheehan, AH. Elazzazi, N. Martínez Moreno, R....
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
- MeSH
- bazální ganglia * MeSH
- dítě MeSH
- dospělí MeSH
- kavernózní hemangiom centrálního nervového systému * chirurgie radioterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- předškolní dítě MeSH
- radiochirurgie * MeSH
- retrospektivní studie MeSH
- senioři MeSH
- thalamus * chirurgie MeSH
- výsledek terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: There are few reports of outcomes following stereotactic radiosurgery (SRS) for the management of cerebral cavernous malformations (CCMs) of the basal ganglia or thalamus. Therefore, the authors aimed to clarify these outcomes. METHODS: Centers participating in the International Radiosurgery Research Foundation were queried for CCM cases managed with SRS from October 2001 to February 2021. The primary outcome of interest was hemorrhage-free survival (HFS) with a secondary outcome of symptomatic adverse radiation events (AREs). Assessment of the association of prognostic factors with HFS was conducted via Kaplan-Meier analysis and log-rank test. Chi-square tests were conducted to assess potential factors associated with the incidence of AREs. RESULTS: Seventy-three patients were identified. The median patient age was 43.5 years (range 4.4-79.5 years). Fifty-nine (80.8%) patients had hemorrhage prior to SRS. The median treatment volume was 0.9 cm3 (range 0.07-10.1 cm3) with a median margin prescription dose (MPD) of 12 Gy (range 10-20 Gy). One-, 3-, 5-, and 10-year HFS were 93.0%, 89.9%, 89.9%, and 83.0%, respectively, with one hemorrhage-related death approximately 1 year after SRS and nearly 60% and 30% of patients having improvement or stability of symptoms, respectively. There was no correlation between lesion size or MPD and HFS. Seven (9.6%) patients experienced AREs (MPDs > 12 Gy in all cases). Lesion size > 1.0 cm3 was correlated with the incidence of an ARE (p = 0.019). Forty-two (93.3%) of 45 patients treated with an MPD ≤ 12 Gy experienced neither hemorrhage nor AREs following SRS versus 17 (60.7%) of 28 patients treated with an MPD > 12 Gy (p = 0.0006). CONCLUSIONS: SRS is a reasonable treatment strategy and confers clinical stability or improvement and hemorrhage avoidance in patients harboring CCMs of the basal ganglia or thalamus. An MPD of approximately 12 Gy is recommended for the management of CCM.
Clinical Oncology Ain Shams University Cairo Egypt
Department of Neurological Surgery Civil Hospices of Lyon France
Department of Neurological Surgery University of Virginia Charlottesville Virginia
Department of Neurosurgery and
Department of Neurosurgery Koc University School of Medicine Istanbul Turkey
Department of Neurosurgery NYU Langone New York New York
Department of Radiation Oncology National Cancer Institute Cairo University Cairo Egypt
Department of Radiosurgery Rúber International Hospital Madrid Spain
Department of Stereotactic and Radiation Neurosurgery Na Homolce Hospital Prague Czech Republic
Departments of14Neurosurgery and
Departments of7Neurosurgery and
Division of Radiation Oncology Department of Oncology University of Alberta Edmonton Alberta Canada
Dominican Gamma Knife Center and Radiology Department CEDIMAT Santo Domingo Dominican Republic
Extended Modular Program Faculty of Medicine Ain Shams University Cairo Egypt
Gamma Knife Center Cairo Nasser Institute Hospital Cairo Egypt
Gamma Knife Center Jewish Hospital Mayfield Clinic Cincinnati Ohio
Neurosurgery Department Faculty of Medicine Benha University Qalubya Egypt
Radiation Therapy Postgraduate Institute of Medical Education and Research Chandigarh India
Citace poskytuje Crossref.org
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- $a Singh, Raj $u 1Department of Radiation Oncology, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio
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- $a Clinical outcomes following stereotactic radiosurgery for cerebral cavernous malformations of the basal ganglia and thalamus / $c R. Singh, C. Dumot, G. Mantziaris, S. Dayawansa, Z. Xu, S. Pikis, S. Peker, Y. Samanci, GD. Ardor, AM. Nabeel, WA. Reda, SR. Tawadros, K. Abdel Karim, AMN. El-Shehaby, RM. Emad Eldin, D. Sheehan, K. Sheehan, AH. Elazzazi, N. Martínez Moreno, R. Martínez Álvarez, R. Liscak, J. May, D. Mathieu, JN. Tourigny, M. Tripathi, A. Rajput, N. Kumar, R. Kaur, P. Picozzi, A. Franzini, H. Speckter, W. Hernandez, A. Brito, RE. Warnick, JD. Alzate, D. Kondziolka, GN. Bowden, S. Patel, JP. Sheehan
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- $a OBJECTIVE: There are few reports of outcomes following stereotactic radiosurgery (SRS) for the management of cerebral cavernous malformations (CCMs) of the basal ganglia or thalamus. Therefore, the authors aimed to clarify these outcomes. METHODS: Centers participating in the International Radiosurgery Research Foundation were queried for CCM cases managed with SRS from October 2001 to February 2021. The primary outcome of interest was hemorrhage-free survival (HFS) with a secondary outcome of symptomatic adverse radiation events (AREs). Assessment of the association of prognostic factors with HFS was conducted via Kaplan-Meier analysis and log-rank test. Chi-square tests were conducted to assess potential factors associated with the incidence of AREs. RESULTS: Seventy-three patients were identified. The median patient age was 43.5 years (range 4.4-79.5 years). Fifty-nine (80.8%) patients had hemorrhage prior to SRS. The median treatment volume was 0.9 cm3 (range 0.07-10.1 cm3) with a median margin prescription dose (MPD) of 12 Gy (range 10-20 Gy). One-, 3-, 5-, and 10-year HFS were 93.0%, 89.9%, 89.9%, and 83.0%, respectively, with one hemorrhage-related death approximately 1 year after SRS and nearly 60% and 30% of patients having improvement or stability of symptoms, respectively. There was no correlation between lesion size or MPD and HFS. Seven (9.6%) patients experienced AREs (MPDs > 12 Gy in all cases). Lesion size > 1.0 cm3 was correlated with the incidence of an ARE (p = 0.019). Forty-two (93.3%) of 45 patients treated with an MPD ≤ 12 Gy experienced neither hemorrhage nor AREs following SRS versus 17 (60.7%) of 28 patients treated with an MPD > 12 Gy (p = 0.0006). CONCLUSIONS: SRS is a reasonable treatment strategy and confers clinical stability or improvement and hemorrhage avoidance in patients harboring CCMs of the basal ganglia or thalamus. An MPD of approximately 12 Gy is recommended for the management of CCM.
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