Development of a model to predict permanent symptomatic postradiosurgery injury for arteriovenous malformation patients
Development of a model to predict permanent symptomatic postradiosurgery injury for arteriovenous malformation patients
复制标题
DOI：
10.1016/s0360-3016(99)00513-1
复制
发表时间：
2000-03-15
影响因子：
7
通讯作者：
Pollock, B
中科院分区：
文献类型：
--
作者：
Flickinger, JC;Kondziolka, D;Pollock, B
目的：为了更好地预测永久性并发症动静脉畸形（AVM）radiosurgery.Methods和Materials：数据从85 AVM患者伽玛刀治疗和337例对照组患者没有并发症的症状并发症进行了评价作为一个多机构研究的一部分。在85例并发症患者中，38例患者被归类为具有永久性症状后遗症（坏死），AVM边缘剂量为10-35戈伊，治疗体积为0.26-47.9 cc，无并发症患者的中位随访时间为45个月（范围：24-92），结果：AVM位置和接受12戈伊或更高剂量的组织体积影响的多变量分析（12-Gy-Volume）允许构建显著的放射外科术后损伤表达（SPIE）评分。按风险和SPIE评分（0-10）增加顺序排列的AVM位置为：额叶、颞叶、脑室内、顶叶、小脑、胼胝体、枕叶、髓质、丘脑、基底节和脑桥/中脑。最终的统计模型根据SPIE评分和Id-Gy-dose预测永久性症状性后遗症的风险。既往出血、边缘剂量和边缘-12-Gy体积（排除靶体积）未显著改善永久性后遗症的风险预测模型（p ≥ 0.39）。结论：AVM放射外科手术产生永久性症状性后遗症的风险随位置和体积（较小的剂量）而显著不同。这些风险可以根据SPIE位置风险评分和12-Gy-Volume进行预测。(C)2000 Elsevier Science Inc.
Purpose: To better predict permanent complications from arteriovenous malformation (AVM) radiosurgery.Methods and Materials: Data from 85 AVM patients who developed symptomatic complications following gamma knife radiosurgery and 337 control patients with no complications were evaluated as part of a multiinstitutional study. Of the 85 patients with complications, 38 patients were classified as having permanent symptomatic sequelae (necrosis), AVM marginal doses varied from 10-35 Gy and treatment volumes from 0.26-47.9 cc, Median follow-up for patients without complications was 45 months (range: 24-92),Results: Multivariate analysis of the effects of AVM location and the volume of tissue receiving 12 Gy or more (12-Gy-Volume) allowed construction of a significant postradiosurgery injury expression (SPIE) score. AVM locations in order of increasing risk and SPIE score (from 0-10) were: frontal, temporal, intraventricular, parietal, cerebellar, corpus callosum, occipital, medulla, thalamus, basal ganglia, and pons/midbrain. The final statistical model predicts risks of permanent symptomatic sequelae from SPIE scores and Id-Gy-Volumes. Prior hemorrhage, marginal dose, and Marginal-12-Gy-Volume (target volume excluded) did not significantly improve the risk-prediction model for permanent sequelae (p greater than or equal to 0.39),Conclusion: The risks of developing permanent symptomatic sequelae from AVM radiosurgery vary dramatically with location and, to a lesser eh-tent, volume. These risks can be predicted according to the SPIE location-risk score and the 12-Gy-Volume. (C) 2000 Elsevier Science Inc.