Clinical outcomes following stereotactic radiosurgery for cerebral cavernous malformations of the basal ganglia and thalamus.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Singh Raj, Dumot Chloe, Mantziaris Georgios, Dayawansa Sam, Xu Zhiyuan, Pikis Stylianos, Peker Selcuk, Samanci Yavuz, Ardor Gokce D, Nabeel Ahmed M, Reda Wael A, Tawadros Sameh R, Abdel Karim Khaled, El-Shehaby Amr M N, Emad Eldin Reem M, Sheehan Darrah, Sheehan Kimball, Elazzazi Ahmed H, Martínez Moreno Nuria, Martínez Álvarez Roberto, Liscak Roman, May Jaromir, Mathieu David, Tourigny Jean-Nicolas, Tripathi Manjul, Rajput Akshay, Kumar Narendra, Kaur Rupinder, Picozzi Piero, Franzini Andrea, Speckter Herwin, Hernandez Wenceslao, Brito Anderson, Warnick Ronald E, Alzate Juan Diego, Kondziolka Douglas, Bowden Greg N, Patel Samir, Sheehan Jason P
Аннотация
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.