Fractionated stereotactic radiation therapy for intracranial arteriovenous malformations

Fractionation of radiotherapy is a radiobiological advantage because the radiation effects on healthy brain tissue are reduced. We used fractionated stereotactic radiotherapy for cerebral arteriovenous malformations employing a modified linear accelerator and a noninvasive stereoadaptor. The treatment was given in two sessions (1,400 cGy x 2). Control angiography at least 2 years after treatment was performed on 20 patients. The malformation was completely eliminated in 14 of 15 patients with small arteriovenous malformations. None of the 5 patients with large malformations had their lesion eliminated, but in 4 the malformation was significantly reduced. Fractionated stereotactic radiation therapy using a conventional accelerator is an effective and safe technique in the treatment of intracranial arteriovenous malformations and compares favorably to radiosurgery.