Proposal for a new prognostic score for linac-based radiosurgery in cerebral arteriovenous malformations
Purpose: We evaluate patient-, angioma-, and treatment-specific factors for successful obliteration of cerebral arteriovenous malformations (AVM) to develop a new appropriate score to predict patient outcome after linac-based radiosurgery (RS). Methods and Materials: This analysis in based on 293 pa...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
1 June 2012
|
| In: |
International journal of radiation oncology, biology, physics
Year: 2012, Volume: 83, Issue: 2, Pages: 525-532 |
| ISSN: | 1879-355X |
| DOI: | 10.1016/j.ijrobp.2011.07.008 |
| Online Access: | Verlag, Volltext: http://dx.doi.org/10.1016/j.ijrobp.2011.07.008 Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0360301611030136 
|
| Author Notes: | Stefanie Milker-Zabel, Annette Kopp-Schneider, Hannah Wiesbauer, Wolfgang Schlegel, Peter Huber, Jürgen Debus, Angelika Zabel-du Bois |
| Summary: | Purpose: We evaluate patient-, angioma-, and treatment-specific factors for successful obliteration of cerebral arteriovenous malformations (AVM) to develop a new appropriate score to predict patient outcome after linac-based radiosurgery (RS). Methods and Materials: This analysis in based on 293 patients with cerebral AVM. Mean age at treatment was 38.8 years (4-73 years). AVM classification according Spetzler-Martin was 55 patients Grade I (20.5%), 114 Grade II (42.5%), 79 Grade III (29.5%), 19 Grade IV (7.1%), and 1 Grade V (0.4%). Median maximum AVM diameter was 3.0 cm (range, 0.3-10 cm). Median dose prescribed to the 80% isodose was 18 Gy (range, 12-22 Gy). Eighty-five patients (29.1%) had prior partial embolization; 141 patients (51.9%) experienced intracranial hemorrhage before RS. Median follow-up was 4.2 years. Results: Age at treatment, maximum diameter, nidus volume, and applied dose were significant factors for successful obliteration. Under presumption of proportional hazard in the dose range between 12 and 22 Gy/80% isodose, an increase of obliteration rate of approximately 25% per Gy was seen. On the basis of multivariate analysis, a prediction score was calculated including AVM maximum diameter and age at treatment. The prediction error up to the time point 8 years was 0.173 for the Heidelberg score compared with the Kaplan-Meier value of 0.192. An increase of the score of 1 point results in a decrease of obliteration chance by a factor of 0.447. Conclusion: The proposed score is linac-based radiosurgery-specific and easy to handle to predict patient outcome. Further validation on an independent patient cohort is necessary. |
|---|---|
| Item Description: | Online 24 October 2011 Gesehen am 29.11.2018 |
| Physical Description: | Online Resource |
| ISSN: | 1879-355X |
| DOI: | 10.1016/j.ijrobp.2011.07.008 |