The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience

Autor: Ahmed Awad, Ameen Alomair, Mohammed Rizwanullah, Adnan Alhebshi, Amr Taha, Faisal Alzorkany, Mohammed Alkafi, Joti Phattacharya, Ahmed Elashwah
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Research in Oncology, Vol 20, Iss 1, Pp 1-8 (2024)
Druh dokumentu: article
ISSN: 2357-0687
2357-0695
DOI: 10.21608/resoncol.2024.258069.1204
Popis: Background: Cerebral arteriovenous malformations (AVMs) are complex, heterogeneous, uncommon lesions that carry a high risk of intracranial hemorrhage with subsequent disability. Aim: To evaluate the outcome of patients with cerebral AVMs treated in our center, King Faisal Specialized Hospital and Research Center (KFSH&RC) Saudi Arabia with SRS using the CyberKnife. Methods: Medical records of patients treated in the above-mentioned way in the period between 2009-2021 were retrospectively evaluated. Results: A total of 51 patients were included in this study. The median age at diagnosis was 31 (3-77) years. Neurological alteration and intracranial hemorrhage were the most common presentations in 24 (47.1%) patients. The mean maximum AVM nidus diameter and volume were 2.9 cm and 5.9 cc respectively. All the patients received SRS using CyberKnife with a median marginal dose of 20 (14-21) Gy over a single fraction. Volume staged treatment was applied in 4 (7.8%) patients. After a median follow-up of 37 (2-170) months, all patients were alive with successful obliteration of the AVM nidus occurring in 31 (60.8%) patients after a median latency period of 27 (4-68.9) months in those who achieved complete obliteration. No patients developed post-SRS hemorrhage and 11 (21.6%) patients developed post-SRS radiological radiation-induced changes of which only 3 (27.3%) patients were symptomatic (in the form of uncontrolled seizures). only SRS dose > 19 Gy was significantly correlated with the obliteration rate, as 79.3% of patients who received SRS dose > 19 Gy achieved obliteration vs 36.4 % only in those who received dose Conclusion: SRS treatment using CyberKnife is effective management for patients with cerebral AVMs without an increase in the incidence of post-SRS hemorrhage, stroke, or death.
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