OBJECT: The aim of this study was to evaluate the causes of treatment failure in patients with arteriovenous malformations (AVMs) who underwent radiosurgery, which is increasingly used as a treatment method for selected, surgically high-risk AVMs. Unfortunately, radiosurgical treatment fails in a small but significant percentage of patients. In the time period covered in this study, 72 patients attained angiographically confirmed cures after radiosurgery and 36 were retreated after the initial radiosurgical treatment failed. METHODS: Using a computerized image fusion technique, the initial radiosurgical dosimetry plan was superimposed on the remaining AVM nidus at the time of retreatment. Twenty-six percent of the retreated cases were found to have AVM niduses outside the original treatment isodose line, which means that targeting error was a factor. The retreated group was also statistically compared with the cured group. CONCLUSIONS: Multivariate analysis revealed that the following factors were statistically significant predictors of treatment failure: increasing AVM size, decreasing treatment dose, and increasing Spetzler-Martin grade.
OBJECT: The aim of this study was to evaluate the causes of treatment failure in patients with arteriovenous malformations (AVMs) who underwent radiosurgery, which is increasingly used as a treatment method for selected, surgically high-risk AVMs. Unfortunately, radiosurgical treatment fails in a small but significant percentage of patients. In the time period covered in this study, 72 patients attained angiographically confirmed cures after radiosurgery and 36 were retreated after the initial radiosurgical treatment failed. METHODS: Using a computerized image fusion technique, the initial radiosurgical dosimetry plan was superimposed on the remaining AVM nidus at the time of retreatment. Twenty-six percent of the retreated cases were found to have AVM niduses outside the original treatment isodose line, which means that targeting error was a factor. The retreated group was also statistically compared with the cured group. CONCLUSIONS: Multivariate analysis revealed that the following factors were statistically significant predictors of treatment failure: increasing AVM size, decreasing treatment dose, and increasing Spetzler-Martin grade.
Authors: Mina G Safain; Jason P Rahal; Ami Raval; Mark J Rivard; John E Mignano; Julian K Wu; Adel M Malek Journal: Neurosurgery Date: 2014-06 Impact factor: 4.654
Authors: Jun Kang; Judy Huang; Philippe Gailloud; Daniele Rigamonti; Michael Lim; Vincent Bernard; Tina Ehtiati; Eric C Ford Journal: Int J Radiat Oncol Biol Phys Date: 2014-07-08 Impact factor: 7.038
Authors: Tim J Kruser; Wolfgang A Tome; Songwon Seo; John S Kuo; Patrick A Turski; Richard J Chappell; Rufus A Scrimger; Minesh P Mehta Journal: J Radiosurg SBRT Date: 2011