重复与初始立体射线手术对内动脉静脉形异常的比较:一个回顾性多中心匹配的队列研究
Eduardo Orrego Gonzalez1, Georgios Mantziaris1, Ahmed Shaaban1
1Department of Neurological Surgery, University of Virginia, Charlottesville, Virginia, USA.
Neurosurgery
|September 16, 2024
概括
对大脑动脉静脉形形的重复立体射线手术 (SRS) 与最初的SRS相比,产生了类似的消灭和辐射诱导的变化. 对于重复的SRS,可能不需要降低剂量,为患者提供可比的结果.
科学领域:
- 神经外科 神经外科
- 辐射瘤学 辐射瘤学
- 放射学 放射学是一门学科.
背景情况:
- 内动脉静脉形 (AVM) 是一种复杂的血管病变.
- 立体射线手术 (SRS) 是AVM的关键治疗方式.
- 有限的数据存在于AVMs重复SRS的结果.
研究的目的:
- 为了比较最初的SRS与重复的SRS对内AVM的神经和放射结果.
- 为了评估两个治疗组之间的消灭率和辐射诱导变化 (RIC).
- 为临床决策提供有关重复SRS程序的信息.
主要方法:
- 在21个中心 (1987-2022) 进行了回顾性匹配队列研究.
- 匹配1:1患者接受初始SRS与AVM的重复SRS.
- 匹配标准包括AVM体积,边缘剂量,静脉排水和位置.
主要成果:
- 每组328名患者 (最初的SRS与重复的SRS).
- 在3年或5年内消灭率没有显著差异 (初始:35.8%/56.7%;重复:33.9%/58.6%).
- 组间的整体RIC,症状RIC和后SRS出血的比较率.
结论:
- 在匹配的队列中,重复SRS提供了与初始SRS相比的消灭和RIC结果.
- 对于重复的SRS,目前的剂量减少策略可能不需要.
- 这些发现支持重复SRS在选择的AVM患者的疗效.
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