Effect of cerebral arteriovenous malformation location on outcomes of repeat, single-fraction stereotactic radiosurgery: a matched-cohort analysis
Rattachement africain : us, fr, cz, tw, es, Égypte, tr, ie, ca, in. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
OBJECTIVE: Patients with deep-seated arteriovenous malformations (AVMs) have a higher rate of unfavorable outcome and lower rate of nidus obliteration after primary stereotactic radiosurgery (SRS). The aim of this study was to evaluate and quantify the effect of AVM location on repeat SRS outcomes. METHODS: This retrospective, multicenter study involved 505 AVM patients managed with repeat, single-session SRS. The endpoints were nidus obliteration, hemorrhage in the latency period, radiation-induced changes (RICs), and favorable outcome. Patients were split on the basis of AVM location into the deep (brainstem, basal ganglia, thalamus, deep cerebellum, and corpus callosum) and superficial cohorts. The cohorts were matched 1:1 on the basis of the covariate balancing score for volume, eloquence of location, and prescription dose. RESULTS: After matching, 149 patients remained in each cohort. The 5-year cumulative probability rates for favorable outcome (probability difference -18%, 95% CI -30.9 to -5.8%, p = 0.004) and AVM obliteration (probability difference -18%, 95% CI -30.1% to -6.4%, p = 0.007) were significantly lower in the deep AVM cohort. No significant differences were observed in the 5-year cumulative probability rates for hemorrhage (probability difference 3%, 95% CI -2.4% to 8.5%, p = 0.28) or RICs (probability difference 1%, 95% CI -10.6% to 11.7%, p = 0.92). The median time to delayed cyst formation was longer with deep-seated AVMs (deep 62 months vs superficial 12 months, p = 0.047). CONCLUSIONS: AVMs located in deep regions had significantly lower favorable outcomes and obliteration rates compared with superficial lesions after repeat SRS. Although the rates of hemorrhage in the latency period and RICs in the two cohorts were comparable, delayed cyst formation occurred later in patients with deep-seated AVMs.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Effect of cerebral arteriovenous malformation location on outcomes of repeat, single-fraction stereotactic radiosurgery: a matched-cohort analysis
- Date Crossref
- 01/06/2024
- Éditeur
- Journal of Neurosurgery Publishing Group (JNSPG)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Neurological Surgery pays non établi dans la noticeÉtablissement de santé
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University of Virginia Department of Neurological Surgery pays non établi dans la noticeUniversité ou école supérieure
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Hospices Civils de Lyon pays non établi dans la noticeÉtablissement de santé
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Na Homolce Hospital Department of Stereotactic and Radiation Neurosurgery pays non établi dans la noticeÉtablissement de santé
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National Yang Ming Chiao Tung University pays non établi dans la noticeUniversité ou école supérieure
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Taipei Veterans General Hospital pays non établi dans la noticeÉtablissement de santé
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Hospital Ruber Internacional Radiosurgery Unit pays non établi dans la noticeÉtablissement de santé
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University of Pittsburgh Department of Neurological Surgery pays non établi dans la noticeUniversité ou école supérieure
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Benha University Neurosurgery Department Benha University, Égypte (code pays fourni par la source)Université ou école supérieure
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Nasser Institute hospital Gamma Knife Center Cairo Gamma Knife Center Cairo, Égypte (code pays fourni par la source)Établissement de santé
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Ain Shams University Clinical Oncology Department Cairo, Égypte (code pays fourni par la source)Université ou école supérieure
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Cairo University National Cancer Institute Cairo University, Égypte (code pays fourni par la source)Université ou école supérieure
Neurological Surgery, Department of Neurological Surgery — University of Virginia et Hospices Civils de Lyon, avec 9 autres affiliations. Pays d’affiliation : Égypte.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.