A Comprehensive Study of Symptomatic Late Radiation-Induced Complications After Radiosurgery for Brain Arteriovenous Malformation: Incidence, Risk Factors, and Clinical Outcomes

World Neurosurgery
Hirotaka HasegawaNobuhito Saito

Abstract

Stereotactic radiosurgery is widely used to treat brain arteriovenous malformation; however, detailed information on late radiation-induced complications (LRICs) is scarce. The goal of the present study was to characterize the incidence, risk factors, and clinical outcomes of LRICs based on our long-term follow-up data. The outcomes of consecutive patients who underwent stereotactic radiosurgery for arteriovenous malformations at our institution in 1990-2010 were analyzed. Cyst formation/encapsulated hematoma (CF/EH) and radiation-induced tumor were defined as LRICs. Cumulative incidence rates were calculated using the Kaplan-Meier method. Risk factors for CF/EH were analyzed using a Cox proportional hazard model. A total of 581 patients with mean and median follow-up periods of 11.8 and 10.1 years, respectively (range, 2.0-26.7 years), were analyzed. CF/EH was observed in 30 patients (5.2%). The median time to progression was 11.8 years (range, 1.9-23.9 years). Cumulative incidence rates were 0.8%, 2.8%, 7.6%, and 9.7% at 5, 10, 15, and 20 years, respectively. A multivariate analysis showed that lobar location and maximal diameter ≥22 mm were significant risk factors for CF/EH. Overall, the functional outcomes were mild, moder...Continue Reading

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Citations

Feb 23, 2019·Nature Reviews. Disease Primers·Dirk De RuysscherFiona Hegi-Johnson
Nov 13, 2019·Reviews on Recent Clinical Trials·Vasileios TzikoulisMaria Tolia
Aug 30, 2020·Cancer radiothérapie : journal de la Société française de radiothérapie oncologique·J JacobD Pasquier

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