Abstract：
BACKGROUND: To explore the therapeutic outcomes of CyberKnife based fractionated stereotactic radiotherapy (CKFRT) for patients with cerebral arteriovenous malformations (AVM).
METHODS: Between January 2008 and October 2020, 45 patients underwent CKFRT for cerebral AVMs as a first treatment. The delineation of AVM targets included AVM nidus. The mean target volume was 4.07 cm3, and 9 lesions (20%) were larger than 10.0 cm3. The mean marginal dose was 24 Gy (range, 20-35 Gy). CKFRT was delivered in median 3 fractions (range, 2 ∼ 5 fractions). AVM obliteration following CKFRT was confirmed by magnetic resonance imaging or angiography.
RESULTS: During a median follow-up of 47 (5-148) months, complete obliteration and partial obliteration of AVM after CKFRT were obtained in 23 (51%) and 13 (29%) patients, respectively. Median time to complete obliteration was 39 (15-63) months. The cumulative probability of complete obliteration rate at 3 years was 47%. Complete obliteration rate of AVM was associated with Radiosurgery-based AVM score, which was consisted of AVM volume, patients age, and AVM location. One (2%) patient had hemorrhage during the follow-up period.
CONCLUSIONS: CKFRT is an effective primary treatment for patients with cerebral AVMs with a low hemorrhage risk.
METHODS: Between January 2008 and October 2020, 45 patients underwent CKFRT for cerebral AVMs as a first treatment. The delineation of AVM targets included AVM nidus. The mean target volume was 4.07 cm3, and 9 lesions (20%) were larger than 10.0 cm3. The mean marginal dose was 24 Gy (range, 20-35 Gy). CKFRT was delivered in median 3 fractions (range, 2 ∼ 5 fractions). AVM obliteration following CKFRT was confirmed by magnetic resonance imaging or angiography.
RESULTS: During a median follow-up of 47 (5-148) months, complete obliteration and partial obliteration of AVM after CKFRT were obtained in 23 (51%) and 13 (29%) patients, respectively. Median time to complete obliteration was 39 (15-63) months. The cumulative probability of complete obliteration rate at 3 years was 47%. Complete obliteration rate of AVM was associated with Radiosurgery-based AVM score, which was consisted of AVM volume, patients age, and AVM location. One (2%) patient had hemorrhage during the follow-up period.
CONCLUSIONS: CKFRT is an effective primary treatment for patients with cerebral AVMs with a low hemorrhage risk.
摘要：
背景：探讨基于射波刀的分割立体定向放疗（CKFRT）对脑动静脉畸形（AVM）患者的治疗效果。
方法：在2008年1月至2020年10月之间，45例患者接受了CKFRT治疗，作为首次治疗。AVM目标的划定包括AVMnidus。平均目标体积为4.07cm3，9个病变（20％）大于10.0cm3。平均边缘剂量为24Gy(范围，20-35Gy）。CKFRT的中位数为3分（范围，2-5分)。通过磁共振成像或血管造影证实CKFRT后的AVM闭塞。
结果：在47（5-148）个月的中位随访期间，在23例（51%）和13例（29%）患者中，CKFRT后AVM完全消失和部分消失，分别。完成闭塞的中位时间为39（15-63）个月。3年完全消失率的累积概率为47％。AVM的完全消失率与基于放射外科的AVM评分相关，它由AVM卷组成，患者年龄,和AVM位置。1例（2%）患者在随访期间出现出血。
结论：CKFRT是低出血风险的脑AVM患者的有效主要治疗方法。
方法：在2008年1月至2020年10月之间，45例患者接受了CKFRT治疗，作为首次治疗。AVM目标的划定包括AVMnidus。平均目标体积为4.07cm3，9个病变（20％）大于10.0cm3。平均边缘剂量为24Gy(范围，20-35Gy）。CKFRT的中位数为3分（范围，2-5分)。通过磁共振成像或血管造影证实CKFRT后的AVM闭塞。
结果：在47（5-148）个月的中位随访期间，在23例（51%）和13例（29%）患者中，CKFRT后AVM完全消失和部分消失，分别。完成闭塞的中位时间为39（15-63）个月。3年完全消失率的累积概率为47％。AVM的完全消失率与基于放射外科的AVM评分相关，它由AVM卷组成，患者年龄,和AVM位置。1例（2%）患者在随访期间出现出血。
结论：CKFRT是低出血风险的脑AVM患者的有效主要治疗方法。
