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The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery
The brainstem arteriovenous malformations (BS-AVMs) have a high morbidity and mortality and stereotactic radiosurgery (SRS) has been widely used to treat BS-AVMs. However, no consensus is reached in the explicit predictors of obliteration for BS-AVMs after SRS. To identify the predictors of clinical...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183693/ https://www.ncbi.nlm.nih.gov/pubmed/34087891 http://dx.doi.org/10.1097/MD.0000000000026203 |
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author | Ai, Xiaolin Xu, Jianguo |
author_facet | Ai, Xiaolin Xu, Jianguo |
author_sort | Ai, Xiaolin |
collection | PubMed |
description | The brainstem arteriovenous malformations (BS-AVMs) have a high morbidity and mortality and stereotactic radiosurgery (SRS) has been widely used to treat BS-AVMs. However, no consensus is reached in the explicit predictors of obliteration for BS-AVMs after SRS. To identify the predictors of clinical outcomes for BS-AVMs treated by SRS, we performed a retrospective observational study of BS-AVMs patients treated by SRS at our institution from 2006 to 2016. The primary outcomes were obliteration of nidus and favorable outcomes (AVM nidus obliteration with mRS score ≤2). For getting the outcomes more accurate, we also pooled the results of previous studies as well as our study by meta-analysis. A total of 26 patients diagnosed with BS-AVMs, with mean volume of 2.6 ml, were treated with SRS. Hemorrhage presentation accounted for 69% of these patients. Overall obliteration rate was 42% with mean follow-up of more than five years and two patients (8%) had a post-SRS hemorrhage. Favorable outcomes were observed in 8 patients (31%). Higher margin dose (>15Gy) was associated with higher obliteration (P = .042) and small volume of nidus was associated with favorable outcomes (P = .036). After pooling the results of 7 studies and present study, non-prior embolization (P = .049) and higher margin dose (P = .04) were associated with higher obliteration rate, in addition, the lower Virginia Radiosurgery AVM Scale (VRAS) was associated with favorable outcomes (P = .02) of BS-AVMs after SRS. In the BS-AVMs patients treated by SRS, higher margin dose (19–24Gy) and non-prior embolization were the independent predictors of higher obliteration rate. In addition, smaller volume of nidus and lower VRAS were the potential predictors of long-term favorable outcomes for these patients. |
format | Online Article Text |
id | pubmed-8183693 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-81836932021-06-07 The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery Ai, Xiaolin Xu, Jianguo Medicine (Baltimore) 5300 The brainstem arteriovenous malformations (BS-AVMs) have a high morbidity and mortality and stereotactic radiosurgery (SRS) has been widely used to treat BS-AVMs. However, no consensus is reached in the explicit predictors of obliteration for BS-AVMs after SRS. To identify the predictors of clinical outcomes for BS-AVMs treated by SRS, we performed a retrospective observational study of BS-AVMs patients treated by SRS at our institution from 2006 to 2016. The primary outcomes were obliteration of nidus and favorable outcomes (AVM nidus obliteration with mRS score ≤2). For getting the outcomes more accurate, we also pooled the results of previous studies as well as our study by meta-analysis. A total of 26 patients diagnosed with BS-AVMs, with mean volume of 2.6 ml, were treated with SRS. Hemorrhage presentation accounted for 69% of these patients. Overall obliteration rate was 42% with mean follow-up of more than five years and two patients (8%) had a post-SRS hemorrhage. Favorable outcomes were observed in 8 patients (31%). Higher margin dose (>15Gy) was associated with higher obliteration (P = .042) and small volume of nidus was associated with favorable outcomes (P = .036). After pooling the results of 7 studies and present study, non-prior embolization (P = .049) and higher margin dose (P = .04) were associated with higher obliteration rate, in addition, the lower Virginia Radiosurgery AVM Scale (VRAS) was associated with favorable outcomes (P = .02) of BS-AVMs after SRS. In the BS-AVMs patients treated by SRS, higher margin dose (19–24Gy) and non-prior embolization were the independent predictors of higher obliteration rate. In addition, smaller volume of nidus and lower VRAS were the potential predictors of long-term favorable outcomes for these patients. Lippincott Williams & Wilkins 2021-06-04 /pmc/articles/PMC8183693/ /pubmed/34087891 http://dx.doi.org/10.1097/MD.0000000000026203 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) |
spellingShingle | 5300 Ai, Xiaolin Xu, Jianguo The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title | The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title_full | The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title_fullStr | The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title_full_unstemmed | The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title_short | The predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
title_sort | predictors of clinical outcomes in brainstem arteriovenous malformations after stereotactic radiosurgery |
topic | 5300 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8183693/ https://www.ncbi.nlm.nih.gov/pubmed/34087891 http://dx.doi.org/10.1097/MD.0000000000026203 |
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