Stereotactic radiosurgery (SRS) for patients with brainstem cerebral cavernous malformations (CCMs): an international, multicentric study

Autor: Sam Dayawansa, Chloe Dumot, Georgios Mantziaris, Zhiyuan Xu, Stylianos Pikis, Selcuk Peker, Yavuz Samanci, Gokce D. Ardor, Ahmed M. Nabeel, Wael A. Reda, Sameh R. Tawadros, Khaled Abdelkarim, Amr M. N. El-Shehaby, Reem M. Emad Eldin, Ahmed H. Elazzazi, Nuria Martínez Moreno, Roberto Martínez Álvarez, Roman Liscak, Jaromir May, David Mathieu, Jean-Nicolas Tourigny, Manjul Tripathi, Akshay Rajput, Narendra Kumar, Rupinder Kaur, Piero Picozzi, Andrea Franzini, Herwin Speckter, Wenceslao Hernandez, Anderson Brito, Ronald E. Warnick, Juan Alzate, Douglas Kondziolka, Greg N. Bowden, Samir Patel, Jason P. Sheehan
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Scientific Reports, Vol 14, Iss 1, Pp 1-9 (2024)
Druh dokumentu: article
ISSN: 2045-2322
DOI: 10.1038/s41598-024-77140-z
Popis: Abstract Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers. Hemorrhagic risk reduction, risk factors of post-SRS hemorrhage, and clinical outcomes were retrospectively analyzed. Most patients had a single (165/170 patients) brainstem CCMs treated; the majority of CCMs (165/181) presented with bleeding. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM (HR: 0.17, p 13 Gy (HR = 2.57, p = 0.044). Adverse radiation effect (ARE) occurred in 9 patients (5.3%) and was symptomatic in four (2.4%). At a median follow-up of 3.4 years (Inter-quartile range: 5.4), 13 patients (8.0%) had a worsened clinical status, with the treated CCM being the cause in 5.6% (10) of the patients. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM and conveyed this benefit with a low risk of advrse radiation effects (ARE) and worsening clinical status.
Databáze: Directory of Open Access Journals
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