A dose-response analysis of arteriovenous malformation obliteration after radiosurgery
A dose-response analysis of arteriovenous malformation obliteration after radiosurgery
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DOI：
10.1016/s0360-3016(96)00316-1
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发表时间：
1996-11-01
影响因子：
7
通讯作者：
Lunsford, LD
中科院分区：
文献类型：
--
作者：
Flickinger, JC;Pollock, BE;Lunsford, LD
用途：虽然放射外科手术是有效的闭塞颅内动静脉畸形（AVM）的病理血管，剂量和体积闭塞的关系还没有得到很好的defined.Methods和Materials：放射外科手术的结果在197例AVM患者3年的血管造影随访进行了分析。体积范围为0.06-18 cc最小靶剂量（D-min）为12.0-25.6戈伊（中位数：20.0戈伊）。随访血管造影显示197例患者中有142例（72%）AVM完全闭塞，20例患者（10%）靶AVM病灶未能闭塞，但在其余35例（18%）发现有残留非靶向AVM病灶的患者中，射野内闭塞是完全的。多变量逻辑回归分析显示，射野内闭塞与D-min（p = 0.04）有显著的独立相关性，但与体积或最大剂量无关。构建了一条用于现场闭塞的S形剂量-反应曲线，该曲线与从总体闭塞数据中预期的剂量-体积-反应关系显著不同。放射外科手术后AVM的射野内闭塞成功率取决于D-min，但似乎不随体积或最大剂量而明显变化，此外，完全闭塞的成功率还受到定义完全AVM病灶的问题的限制。版权所有（C）1996 Elsevier Science Inc.
Purpose: Although radiosurgery is effective in obliterating the pathologic vessels of intracranial arteriovenous malformations (AVM), the relationships of both dose and volume to obliteration have not been well defined.Methods and Materials: The results of radiosurgery in 197 AVM patients with 3-year angiographic follow-up were analyzed. Volume varied from 0.06-18 cc (median: 4.1 cc), and minimum target dose (D-min) varied from 12.0-25.6 Gy (median: 20.0 Gy).Results: Follow-up angiography revealed complete AVM obliteration in 142 out of 197 patients (72%), The targeted AVM nidus failed to obliterate in 20 patients (10%), but in-field obliteration was complete in the remaining 35 patients (18%) discovered to have residual untargeted AVM nidus, Multivariate logistic regression a analysis of in-field obliteration revealed a significant independent correlation with D-min (p = 0.04), but not with volume or maximum dose. A sigmoid dose-response curve for in-field obliteration was constructed that significantly differed from the dose-volume-response relationships that would have been expected from overall obliteration data.Conclusions: The success rate for in-field obliteration of AVM after radiosurgery depends on D-min but does not appear to change appreciably with volume or maximum dose, Success rates for complete obliteration additionally are limited by problems defining the complete AVM nidus. Copyright (C) 1996 Elsevier Science Inc.