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Failure of conventionally fractionated radiotherapy to decrease the risk of hemorrhage in inoperable arteriovenous
Neurosurgery
|June 1, 1992
Summary
Conventional fractionated radiotherapy for arteriovenous malformations (AVMs) showed a similar bleeding risk to untreated patients. Stereotactic radiosurgery may be a better option for inoperable AVMs.
Area of Science:
- Neurology
- Radiation Oncology
- Vascular Surgery
Background:
- Arteriovenous malformations (AVMs) are complex vascular lesions that can lead to significant morbidity and mortality.
- Conventional fractionated radiotherapy has been used to treat inoperable AVMs, but its efficacy in reducing hemorrhage risk is debated.
Purpose of the Study:
- To evaluate the long-term effectiveness of conventional fractionated radiotherapy in managing arteriovenous malformations (AVMs).
- To assess the impact of this treatment on the risk of hemorrhage in patients with inoperable AVMs.
Main Methods:
- Retrospective analysis of 26 patients with AVMs treated between 1965 and 1986.
- Patients received conventional fractionated radiotherapy with doses ranging from 40 to 54 Gy.
- Median follow-up duration was 14.5 years, with assessment of hemorrhage events and angiographic AVM persistence.
Main Results:
- Eleven patients experienced hemorrhage post-treatment.
- The actuarial annual risk of bleeding was 2.3%, comparable to untreated AVM patients.
- Angiography confirmed AVM persistence in 10 out of 11 evaluated patients.
Conclusions:
- Conventional fractionated radiotherapy at standard doses has a limited impact on reducing hemorrhage risk in inoperable AVMs.
- The findings suggest that stereotactic external beam radiotherapy or radiosurgery should be considered as preferred treatment options when feasible.