Gamma Knife Radiosurgery of Brainstem Cavernous Malformations
Gamma Knife Radiosurgery of Brainstem Cavernous Malformations
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DOI：
10.1159/000452844
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Reyns, Nicolas
中科院分区：
文献类型：
--
作者：
Aboukais, Rabih;Estrade, Laurent;Reyns, Nicolas
背景/目的：本研究旨在评价伽玛刀放射治疗出血性脑干海绵状畸形（CMs）的疗效和发病率。方法：我们纳入了2007年1月至2012年12月在我院接受GKS治疗出血性脑干CM的所有患者。当外科手术被评估为非常危险时，GKS享有特权。平均辐射剂量14.8 Gy，平均靶体积0.282 cm(3)。所有患者都参加了预定的临床随访。治疗后6个月和1年后分别进行MRI检查，所有患者每年进行一次MRI随访。结果：19例患者，平均年龄36.7岁。平均随访时间为51.2个月。GKS前的年出血率（AHR）为27.31%，GKS后2年为2.46%，GKS后2年为2.46%。GKS后AHR显著降低（p < 0.001）。结论：当脑干CM患者的手术存在神经系统并发症的高风险时，应建议行GKS。与先前的文献结果相比，可以讨论比本研究应用的剂量更低的剂量。(C) 2016 S. Karger AG，巴塞尔
Background/Aims: Our study aimed to evaluate the efficiency and morbidity of Gamma Knife radiosurgery (GKS) in the treatment of hemorrhagic brainstem cavernous malformations (CMs). Methods: We included in this study all patients who underwent GKS for the treatment of a hemorrhagic brainstem CM(s) in our institution between January 2007 and December 2012. The GKS was privileged when the surgical procedure was evaluated as very risky. The mean dose of radiation was 14.8 Gy, and the mean target volume was 0.282 cm(3). All patients participated in a scheduled clinical follow-up. The posttreatment MRI was performed after 6 months and after 1 year, and then all patients had an annual MRI follow-up. Results: There were 19 patients with a mean age of 36.7 years. The mean follow-up period was 51.2 months. The annual hemorrhage rate (AHR) was 27.31% before GKS, 2.46% during the first 2 years following the GKS, and 2.46% after the first 2 years following the GKS. The decrease in AHR after GKS was significant (p < 0.001). Conclusion: GKS should be suggested when the surgical procedure harbors a high risk of neurological morbidity in patients with brainstem CM. Compared to prior literature results, a lower dose than applied in this study could be discussed. (C) 2016 S. Karger AG, Basel