Frameless versus frame-based stereotactic radiosurgery for intracranial arteriovenous malformations: A propensity-matched analysis.

Autor:	He Z; Department of Neurosurgery, Tuen Mun Hospital, N.T., Hong Kong, China., Ho MKJ; Department of Neurosurgery, Tuen Mun Hospital, N.T., Hong Kong, China., Lee WYV; Department of Clinical Oncology, Tuen Mun Hospital, N.T., Hong Kong, China., Law HY; Department of Neurosurgery, Tuen Mun Hospital, N.T., Hong Kong, China., Wong YWV; Department of Clinical Oncology, Tuen Mun Hospital, N.T., Hong Kong, China., Leung TW; Department of Clinical Oncology, Tuen Mun Hospital, N.T., Hong Kong, China., Mui WH; Department of Clinical Oncology, Tuen Mun Hospital, N.T., Hong Kong, China., Wong ST; Department of Neurosurgery, Tuen Mun Hospital, N.T., Hong Kong, China., Wong CSF; Department of Clinical Oncology, Tuen Mun Hospital, N.T., Hong Kong, China., Yam KY; Department of Neurosurgery, Tuen Mun Hospital, N.T., Hong Kong, China.
Jazyk:	angličtina
Zdroj:	Clinical and translational radiation oncology [Clin Transl Radiat Oncol] 2023 May 26; Vol. 41, pp. 100642. Date of Electronic Publication: 2023 May 26 (Print Publication: 2023).
DOI:	10.1016/j.ctro.2023.100642
Abstrakt:	Objective: The frameless linear accelerator (LINAC) based stereotactic radiosurgery (SRS) has been evolving with a reduction in patient discomfort. However, there was limited evidence comparing frame-based and frameless SRS for intracranial arteriovenous malformations (AVM). We aimed to compare the treatment outcomes between frame-based and frameless LINAC SRS. Materials and Methods: This retrospective cohort compared the outcomes of frame-based LINAC SRS (1998-2009) with frameless LINAC SRS (2010-2020). The primary outcome was the obliteration rate. The other outcomes included the neurological, radiological, and functional outcomes after SRS. A matched cohort was identified by propensity scores for further comparisons. Results: A total of 65 patients were included with a mean follow-up time of 13.2 years (158.5 months). There were 40 patients in the frame-based group and 25 patients in the frameless group. The overall obliteration rate was comparable (Frame-based 82.5% vs Frameless 80.0%, p = 0.310) and not significantly different over time (log-rank p = 0.536). The crude post-SRS hemorrhage rate was 1.5% and the incidence was 0.3 per 100 person-years. There were 67.7% of patients with AVM obliteration without new persistent neurological deficits at the last visit and 56.9% of patients with AVM obliteration without any deficits (transient or persistent) during the entire follow-up period. Four patients (8.0%) developed late onset persistent adverse radiation effects (more than 96 months after SRS) among 50 patients with more than 8-year surveillance. In the propensity-matched cohort of 42 patients, there was no significant difference in AVM obliteration (Frame-based vs Frameless, log-rank p = 0.984). Conclusion: Frameless and frame-based LINAC SRS have comparable efficacy in intracranial AVM obliteration. A longer follow-up duration may further characterize the rate of late adverse radiation effects in frameless SRS. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2023 The Authors.)
Databáze:	MEDLINE
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