Gamma Knife radiosurgery for cerebral cavernous malformation

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作者
Cheng-Chia Lee
Wei-Hsin Wang
Huai-Che Yang
Chung-Jung Lin
Hsiu-Mei Wu
Yen-Yu Lin
Yong-Sin Hu
Ching-Jen Chen
Yu-Wei Chen
Chien-Chen Chou
Yo-Tsen Liu
Wen-Yuh Chung
Cheng-Ying Shiau
Wan-Yuo Guo
David Hung-Chi Pan
Sanford P. C. Hsu
机构
[1] Taipei Veterans General Hospital,Department of Neurosurgery, Neurological Institute
[2] Taipei Veterans General Hospital,Department of Radiology
[3] National Yang-Ming University,School of Medicine
[4] Taipei Veterans General Hospital,Cancer Center
[5] University of Virginia Health System,Department of Neurological Surgery
[6] Shuang Ho Hospital,Department of Neurosurgery
[7] Taipei Medical University,Department of Neurology
[8] Neurological Institute,Brain Research Center
[9] Taipei Veterans General Hospital,Institute of Brain Science
[10] National Yang‐Ming University,undefined
[11] National Yang-Ming University,undefined
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摘要
This is a retrospective study examining the efficacy and safety of Gamma Knife radiosurgery (GKS) in treating patients with cerebral cavernous malformations (CCMs). Between 1993 and 2018, 261 patients with 331 symptomatic CCMs were treated by GKS. The median age was 39.9 years and females were predominant (54%). The median volume of CCMs was 3.1 mL. The median margin dose was 11.9 Gy treat to a median isodose level of 59%. Median clinical and imaging follow-up times were 69 and 61 months, respectively. After the initial hemorrhage that led to CCM diagnosis, 136 hemorrhages occurred in the period prior to GKS (annual incidence = 23.6%). After GKS, 15 symptomatic hemorrhages occurred within the first 2 years of follow-up (annual incidence = 3.22%), and 37 symptomatic hemorrhages occurred after the first 2 years of follow-up (annual incidence = 3.16%). Symptomatic radiation-induced complication was encountered in 8 patients (3.1%). Mortality related to GKS occurred in 1 patient (0.4%). In conclusion, GKS decreased the risk of hemorrhage in CCM patients presenting with symptomatic hemorrhage. GKS is a viable alternative treatment option for patients with surgically-inaccessible CCMs or significant medical comorbidities.
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