PROBABILITY OF OBLITERATION AND MANAGEMENT RISK FOLLOWING GAMMA KNIFE SURGERY FOR CEREBRAL AVM
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概要
- 論文の詳細を見る
In order to define the optimal treatment for an AVM patient, the probability of cure and the management risk following the treatment must be estimated before the treatment. Here, Gamma Knife surgery has an advantage over microsurgery and embolization with it's reproducibility within the variability of the individual radiation sensitivity. Based on more than 2000 treatments, we have developed models to predict the probability for obliteration, the risk for radioinduced complications and the probability for a post treatment hemorrhage within the first two years following a Gamma Knife treatment. The factors determining the overall outcome are the absorbed dose in the target and the brain, the AVM volume and location and the age and clinical history of the patient. The probability for obliteration equals 35, 69<SUP>*</SUP> ln (D<SUB>min</SUB>) -39, 66 and is AVM volume independent. The risk for radioinduced complications relates to the average dose in the 20cm<SUP>3</SUP> tissue receiving the most radiation, and it is also related to the clinical history of the patient and the AVM location. Finally, the risk for post treatment hemorrhage increases with the age of the patient, and is higher for larger AVM. It decreases with increasing amount of radiation given, and it is independent of the clinical history of the patient. For retreatments, the model for prediction of obliteration is valid, but the risk for radioinduced complications is higher and the risk for post treatment hemorrhage lower as compared to following the first treatment.
- 北関東医学会の論文
著者
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Lax Ingmar
Department of Neurosurgery (BK) and Hospital Physics (IL) Karolinska Hospital
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Karlsson Bengt
Department of Neurosurgery (BK) and Hospital Physics (IL) Karolinska Hospital