Stereotactic heavy-charged-particle Bragg peak radiosurgery for the treatment of intracranial arteriovenous malformations in childhood and adolescence.
Stereotactic heavy-charged-particle Bragg peak radiosurgery for the treatment of intracranial arteriovenous malformations in childhood and adolescence.
复制标题
立体定向重带电粒子布拉格峰放射外科治疗儿童和青少年颅内动静脉畸形。
作者：
R. P. Levy;J. Fabrikant;K. Frankel;M. Phillips;J. Lyman
在加州大学伯克利分校的劳伦斯伯克利实验室184英寸同步回旋加速器的立体定向重电荷粒子布拉格峰值放射外科治疗下，40名6至18岁的患者因无法手术的颅内动静脉畸形(AVM)而接受治疗。本文描述了该年龄段患者的选择程序，治疗方案，以及立体定向放射外科的神经学和神经放射学反应。处理后的动静脉动静脉畸形的体积从265mm3到6万mm3不等。结果是有利的：到目前为止，25名患者中有20名患者在治疗后1年内动静脉动静脉畸形消失大于或等于50%，18名患者中有14名在治疗后2年内动静脉动静脉畸形完全消失。两名患者在治疗后12个月内因接受放射外科治疗的动静脉动静脉畸形出血，但此后再无出血。并发症包括血管源性水肿和动脉闭塞；三名患者的神经功能恶化是肯定的或可能的治疗后遗症。讨论了该方法的优点和局限性。
Forty patients aged 6 to 18 years have now been treated for inoperable intracranial arteriovenous malformations (AVMs) using stereotactic heavy-charged-particle Bragg peak radiosurgery at the Lawrence Berkeley Laboratory 184-inch Synchrocyclotron at the University of California, Berkeley. This paper describes the procedures for selection of patients, the treatment protocol, and the neurological and neuroradiological responses to stereotactic radiosurgery in this age group. The volumes of the treated AVMs ranged from 265 mm3 to 60,000 mm3. The results are favorable: thus far, 20 of 25 patients have experienced greater than or equal to 50% obliteration of their AVMs within 1 year after treatment, and 14 of 18 patients have experienced total obliteration of the AVM by 2 years after treatment. Two patients hemorrhaged from radiosurgically treated AVMs within 12 months after treatment, but none thereafter. Complications include vasogenic edema and arterial occlusion; three patients have had neurological worsening as definite or possible sequelae of treatment. The strengths and limitations of the method are discussed.