保持一致的-60剂量增加了脑动脉静脉形管理中的放射性手术结果
Yudai Hirano1, Yuki Shinya1, Hirotaka Hasegawa1
1Department of Neurosurgery, The University of Tokyo Hospital, Tokyo 113-8655, Japan.
概括
更高的-60剂量率 (Co-60 DR) 显著提高了大脑动脉静脉变异 (AVM) 的立体射线手术 (SRS) 消灭率. 这种方法还可以减少所有AVM大小的SRS后出血.
科学领域:
- 神经外科 神经外科
- 辐射瘤学 辐射瘤学
- 放射性外科手术 放射性外科
背景情况:
- -60剂量率 (Co-60 DR) 对大脑动脉静脉形形 (AVM) 的立体射线手术 (SRS) 结果的影响需要进一步澄清.
- 本研究研究了Co-60 DR与AVM治疗疗效之间的关系.
研究的目的:
- 为了确定Co-60 DR和AVM消除率之间的关联,在SRS之后.
- 评估Co-60 DR对SRS后出血事件的影响.
主要方法:
- 在1990年至2020年期间接受治疗的772名AVM患者的回顾性分析.
- 患者分为高 (≥2.4 Gy/min) 和低 Co-60 DR 组.
- 根据体体积分类的AVM:小 (<5毫升),中等 (5-10毫升) 和大 (≥10毫升).
主要成果:
- 高Co-60 DR显著增加了大型AVM的累积消灭率 (84%与5年后45%相比; p=0.011).
- 多变量分析证实大AVM的高DR组中消除率较高 (aHR=1.78;p=0.049).
- 在整个队列中,高Co-60DR显著降低了SRS后出血率 (2.5%与5年后的5.3%相比; p=0.035),通过多变量分析证实 (aHR=0.47; p=0.026).
结论:
- 更高的Co-60 DR似乎可以提高大型AVM的SRS效率.
- 升高的Co-60 DR可能会降低AVM患者SRS后出血的风险.
- 保持较高的Co-60 DR可能会导致AVM放射性外科手术中更有利的结果.
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