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- W2507380545 abstract "BACKGROUND: Incompletely obliterated cerebral arteriovenous malformations (AVMs) after initial treatment with stereotactic radiosurgery (SRS) can be treated with a repeat session of SRS. However, the relative efficacy of repeat vs initial SRS is not well specified. OBJECTIVE: To retrospectively compare in matched cohorts the outcomes of repeat vs initial SRS for the treatment of matched cohorts with angioarchitecturally similar AVMs. METHODS: We studied a data set of patients with AVM treated with radiosurgery during the period spanning 1989 to 2013. Patients with AVM who underwent repeat SRS with radiologic follow-up of ≥2 years or nidus obliteration were identified for the study and matched, in a 1:1 fashion that was blinded to outcome, to patients with previously untreated AVMs who underwent initial SRS. Statistical analyses were performed to compare the outcomes after repeat vs initial SRS. RESULTS: The matching approach resulted in 84 patients for the repeat and the initial SRS cohort (mean margin doses, 20.7 and 20.9 Gy, respectively; P = .74). In the repeat SRS cohort, obliteration was achieved in 67%; the radiologic, symptomatic, and permanent radiation-induced change rates were 35%, 10%, and 4%, respectively; and the post-SRS hemorrhage rate was 3.1%/y. Compared with the initial SRS cohort, the repeat SRS cohort had significantly lower obliteration rates (P = .04) and higher post-SRS hemorrhage rates (P = .04). The radiation-induced change rates of the 2 cohorts were not significantly different. CONCLUSION: Repeat SRS yields considerably poorer outcomes than initial SRS for angioarchitecturally comparable AVMs. Further studies in AVM radiobiology and vascular structure are necessary to elucidate this potentially differential response. Abbreviations: AVM, arteriovenous malformation RIC, radiation-induced change RBAS, radiosurgery-based arteriovenous malformation score SRS, stereotactic radiosurgery VRAS, virginia radiosurgery AVM scale" @default.
- W2507380545 created "2016-09-16" @default.
- W2507380545 creator A5032187519 @default.
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- W2507380545 date "2016-11-01" @default.
- W2507380545 modified "2023-10-18" @default.
- W2507380545 title "Worse Outcomes After Repeat vs Initial Stereotactic Radiosurgery for Cerebral Arteriovenous Malformations" @default.
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- W2507380545 doi "https://doi.org/10.1227/neu.0000000000001409" @default.
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- W2507380545 hasPublicationYear "2016" @default.
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