gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

The role of radiosurgery in cerebral arteriovenous malformations treatment

Die Bedeutung der Radiochirurgie in der Behandlung von zerebralen arerio-venösen Malformationen

Meeting Abstract

  • corresponding author S. Heinze - Klinik für Neurochirurgie, Universitätsklinikum Marburg
  • M. Groß - Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Marburg
  • O. Bozinov - Klinik für Neurochirurgie, Universitätsklinikum Marburg
  • U. Sure - Klinik für Neurochirurgie, Universitätsklinikum Marburg
  • R. Engenhart-Cabillic - Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Marburg
  • H. Bertalanffy - Klinik für Neurochirurgie, Universitätsklinikum Marburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.03.09

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc229.shtml

Published: April 11, 2007

© 2007 Heinze et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: The modern management of cerebral arteriovenous malformations (AVMs) is based on three therapeutic modalities: microneurosurgery, endovascular embolization, and stereotactic radiosurgery. To schedule individual treatment plan a weekly interdisciplinary conference is performed at our insitute. To study the role of radiosurgical treatment we analysed retrospectively the decisions in 36 cases during 2005. Additionally we analysed rate of obliteration of 97 patients treated between 1995 and 2005 by radiosurgery alone.

Methods: We reviewed the protocols of our weekly interdisciplinary tumor board for AVM patients and worked out the inidividual treatment decision. Additionally the department of radiotherapy reviewed all AVM patients treated by radiosurgery concerning obliteration rate and observed toxicity reactions.

Results: For 36 patients with cerebral AVMs 15 different treatment plans were created in 2005. More than 60% of the designed treatment plans contained radiosurgery. In 6 patients radiosurgery alone was recommended, 5 patients were planned for embolisation as first step and than radiosurgery, 5 patients were planned for embolisation as first step and alternatively radiosurgery or microsurgery as second step, 3 patients were offered radiosurgery alternatively microsurgery as treatment. 4 other individual plans contained radiosurgery as a component. Obliteration rate for 97 patients treated by radiosurgery between 1995 and 2005 was 61%. Toxicity grade I and II was seen in 5%, toxicity grade III was observed in 4%.

Conclusions: Radiosurgery is an important component of interdisciplinary treatment of cerebral AVMs. Obliteration rate at our institute is still within the range presented in literature (60 to 80%). One reason for a relatively low obliteration rate at our institute could be the high percentage of patients presented for radiosurgery containing more difficult AVMs (Spetzler-Martin-Grade IV and V).