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Prediction of Obliteration of Arteriovenous Malformations after Radiosurgery: the Obliteration Prediction Index

Published online by Cambridge University Press:  18 September 2015

Michael Schwartz ,
Katharina Sixel ,
Charlene Young ,
Andras Kemeny ,
David Forster ,
Lee Walton  and
Edmee Franssen
Michael Schwartz*
Affiliation:
Sunnybrook Health Science Centre Toronto-Sunnybrook Regional Cancer Centre, Toronto
Katharina Sixel
Affiliation:
Toronto-Sunnybrook Regional Cancer Centre, Toronto
Charlene Young
Affiliation:
Sunnybrook Health Science Centre Toronto-Sunnybrook Regional Cancer Centre, Toronto
Andras Kemeny
Affiliation:
the Royal Hallamshire Hospital, Sheffiel , United Kingdom.
David Forster
Affiliation:
the Royal Hallamshire Hospital, Sheffiel , United Kingdom.
Lee Walton
Affiliation:
the Royal Hallamshire Hospital, Sheffiel , United Kingdom.
Edmee Franssen
Affiliation:
Sunnybrook Health Science Centre Toronto-Sunnybrook Regional Cancer Centre, Toronto
*
Sunnybrook Health Science Centre, 2075 Bayview Avenue, Suite A129, Toronto, Ontario, Canada M4N 3M5
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Abstract:

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Objective:

To describe the response to single dose photon stereotactic radiosurgery of arteriovenous malformations (AVMs) so that the probability of success or failure of treatment may be predicted for the individual patient.

Method:

The obliteration prediction index (OPI) was calculated for AVMs by dividing the marginal dose of radiation in Gray (Gy) by the lesion diameter in centimetres in cohorts of 42 patients treated with the modified linear accelerator at Toronto-Sunnybrook Regional Cancer Centre and 394 patients treated with the gamma unit at the Royal Hallamshire Hospital, Sheffield, United Kingdom. Patients were grouped into ranges by OPI and the proportion of success and failure was calculated for each group. An exponential function [P = 1-A•e(-B-OPI)] was fitted to the data by the least squares method.

Results:

Despite systematic differences in radiation treatment, that is, marginal doses of 15 and 20 Gy in Toronto and most Sheffield patients with a marginal dose of 25 Gy, the resultant data points exhibited similar behaviour.

Conclusion:

The function [P = 1-A•e(-B-OPI)] partly describes the biological effect of radiation and is independent of the radiation device used. Radiosurgery centres can use this model to facilitate predictions of successful treatment for individual patients.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 24 , Issue 2 , May 1997 , pp. 106 - 109
Copyright
Copyright © Canadian Neurological Sciences Federation 199

References

REFERENCES

1.Colombo, F, Pozza, F, Chierego, G, et al. Linear accelerator radiosurgery of cerebral arteriovenous malformations: an update. Neurosurgery 1994; 34 (1): 14–21.Google ScholarPubMed
2.Friedman, WA, Bova, FJ, Mendenhall, WM. Linear accelerator radiosurgery for arteriovenous malformations: the relationship of size to outcome. J Neurosurg 1995; 82: 180–189.CrossRefGoogle ScholarPubMed
3.Lunsford, LD, Kondziolka, D, Flickinger, JC, et al. Stereotactic radiosurgery for arteriovenous malformations of the brain. J Neurosurg 1991; 75: 512–524.CrossRefGoogle ScholarPubMed
4.Steiner, L, Lindquist, C, Adler, JR, et al. Clinical outcome of radiosurgery for cerebral arteriovenous malformations. J Neurosurg 1992; 77: 1–8.CrossRefGoogle ScholarPubMed
5.Pollock, BE, Kondziolka, D, Lunsford, LD, et al. Repeat stereotactic radiosurgery of arteriovenous malformations: factors associated with incomplete obliteration. Neurosurgery 1996; 38 (2): 318–324.CrossRefGoogle ScholarPubMed
6.Engenhart, R, Wowra, B, Debus, J, et al. The role of high-dose, single-fraction irradiation in small and large intracranial arteriovenous malformations. Int J Radiat Oncol Biol Phys 1994; 30 (3): 521–529.CrossRefGoogle ScholarPubMed
7.Coffey, RJ, Lunsford, LD, Bissonette, D, et al. Stereotactic Gamma radiosurgery for intracranial vascular malformations and tumors: report of the initial North American experience in 331 patients. Stereotact Funct Neurosurg 1990; 54…55: 535–540.CrossRefGoogle ScholarPubMed
8.Sebag-Montefiore, DJ, Doughty, D, Biggs, D, et al. Stereotactic multiple arc radiotherapy. 1. Vascular malformations of the brain: an analysis of the first 108 patients. Br J Neurosurg 1995; 9: 441–452.CrossRefGoogle Scholar
9.Podgorsak, EB, Olivier, A, Pla, M, et al. Dynamic stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 1988; 14: 115–126.CrossRefGoogle ScholarPubMed
10.Souhami, L, Olivier, A, Podgorsak, EB, et al. Radiosurgery of cerebral arteriovenous malformations with the dynamic stereotactic irradiation. Int J Radiat Oncol Biol Phys 1990; 19: 775–782.CrossRefGoogle ScholarPubMed
11.O’Brien, PF, Gillies, BA, Schwartz, M, et al. Radiosurgery with unflattened 6-MV photon beams. Med Phys 1991; 18 (3): 519–521.CrossRefGoogle ScholarPubMed
12.Gillies, BA, O’Brien, PF, McVittie, R, et al. Engineering modifications for dynamic stereotactically assisted radiotherapy. Med Phys 1993; 20 (5): 1491–1495.CrossRefGoogle ScholarPubMed
13.Walton, L, Bomford, CK, Ramsden, D. The Sheffield stereotactic radiosurgery unit: physical characteristics and principles of operation. Bri J Radiol 1987; 60: 897–906.CrossRefGoogle ScholarPubMed
14.Dias, PS, Forster, DMC. Management of cerebrovascular malformations. British J Hospital Med 1989; 42 (5): 372–384.Google ScholarPubMed
15.Kemeny, AA, Dias, P, Forster, DM. Results of stereotactic radiosurgery of arteriovenous malformations: an analysis of 52 cases. J Neurol Neurosurgery Psychiatry 1989; 52: 554–558.CrossRefGoogle ScholarPubMed
16.Guo, WY, Karlsson, B, Ericson, K, et al. Even the smallest remnant of an AVM constitutes a risk of further bleeding. Acta Neurochirurgica 1993; 212–215.CrossRefGoogle ScholarPubMed
17.Marks, LB, Spencer, DP. The influence of volume on the tolerance of the brain to radiosurgery. J Neurosurg 1991; 75 177–180.CrossRefGoogle ScholarPubMed
18.Flickinger, JC, Lunsford, LD, Kondziolka, D, et al. Radiosurgery and brain tolerance: an analysis of neurodiagnostic imaging changes after Gamma Knife radiosurgery for arteriovenous malformations. Int J Radiat Oncol Biol Phys 1992; 23: 19–26.CrossRefGoogle ScholarPubMed
19.Sutcliffe, JC, Forster, DMC, Walton, L, et al. Untoward clinical effects after stereotactic radiosurgery for intracranial arteriovenous malformations. British J Neurosurg 1992; 6: 177–185.CrossRefGoogle ScholarPubMed