Proposal for a new prognostic score for linac-based radiosurgery in cerebral arteriovenous malformations

• Verfasst von: Milker-Zabel, Stefanie [VerfasserIn]
• Verfasst von: Kopp-Schneider, Annette [VerfasserIn]
• Verfasst von: Wiesbauer, Hannah Judith Stefanie [VerfasserIn]
• Verfasst von: Schlegel, Wolfgang [VerfasserIn]
• Verfasst von: Huber, Peter E. [VerfasserIn]
• Verfasst von: Debus, Jürgen [VerfasserIn]
• Verfasst von: Zabel-du Bois, Angelika [VerfasserIn]
• Titel: Proposal for a new prognostic score for linac-based radiosurgery in cerebral arteriovenous malformations
• Verf.angabe: Stefanie Milker-Zabel, Annette Kopp-Schneider, Hannah Wiesbauer, Wolfgang Schlegel, Peter Huber, Jürgen Debus, Angelika Zabel-du Bois
• E-Jahr: 2012
• Jahr: 1 June 2012
• Umfang: 8 S.
• Fussnoten: Online 24 October 2011 ; Gesehen am 29.11.2018
• Titel Quelle: Enthalten in: International journal of radiation oncology, biology, physics
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1975
• Jahr Quelle: 2012
• Band/Heft Quelle: 83(2012), 2, Seite 525-532
• ISSN Quelle: 1879-355X
• DOI: doi:10.1016/j.ijrobp.2011.07.008
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Arteriovenous malformations
• Sach-SW: AVM
• Sach-SW: Linac-based
• Sach-SW: Prognostic factors
• Sach-SW: Radiosurgery
• Sach-SW: Score
• K10plus-PPN: 1584631333

Abstract

Purpose: We evaluate patient-, angioma-, and treatment-specific factors for successful obliteration of cerebral arteriovenous malformations (AVM) to develop a new appropriate score to predict patient outcome after linac-based radiosurgery (RS). Methods and Materials: This analysis in based on 293 patients with cerebral AVM. Mean age at treatment was 38.8 years (4-73 years). AVM classification according Spetzler-Martin was 55 patients Grade I (20.5%), 114 Grade II (42.5%), 79 Grade III (29.5%), 19 Grade IV (7.1%), and 1 Grade V (0.4%). Median maximum AVM diameter was 3.0 cm (range, 0.3-10 cm). Median dose prescribed to the 80% isodose was 18 Gy (range, 12-22 Gy). Eighty-five patients (29.1%) had prior partial embolization; 141 patients (51.9%) experienced intracranial hemorrhage before RS. Median follow-up was 4.2 years. Results: Age at treatment, maximum diameter, nidus volume, and applied dose were significant factors for successful obliteration. Under presumption of proportional hazard in the dose range between 12 and 22 Gy/80% isodose, an increase of obliteration rate of approximately 25% per Gy was seen. On the basis of multivariate analysis, a prediction score was calculated including AVM maximum diameter and age at treatment. The prediction error up to the time point 8 years was 0.173 for the Heidelberg score compared with the Kaplan-Meier value of 0.192. An increase of the score of 1 point results in a decrease of obliteration chance by a factor of 0.447. Conclusion: The proposed score is linac-based radiosurgery-specific and easy to handle to predict patient outcome. Further validation on an independent patient cohort is necessary.