伽玛刀放射治疗脑动静脉畸形后的并发症：症状性放射性坏死的预测因素

IF 1.9 3区医学 Q3 CLINICAL NEUROLOGY

Acta Neurochirurgica Pub Date : 2025-04-23 DOI:10.1007/s00701-025-06532-5

Popadic Branko, Amedeo Cervo, Antonio Macera, Guglielmo Pero, Giada Valente, Florian Scheichel, Camillo Sherif, Marco Picano, Marco Cenzato, Alessandro La Camera, Mariangela Piano

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引用次数: 0

摘要

目的本研究旨在调查伽玛刀放射外科手术（GKRS）治疗 AVM 后的并发症以及症状性放射坏死的预测因素。方法对 2008 年至 2016 年期间接受 GKRS 治疗的 AVM 进行了一项回顾性单中心研究。70%的患者出现了动静脉畸形阻塞，45%的患者出现了辐射诱导病变（RIC）。13例患者（6.2%）出现了症状性放射性坏死。此外，12 名患者（5.7%）出现了潜伏期出血。在单变量分析中，症状性放射性坏死的预测因素是 12 Gy 容量（p = 0.007）、RIC 等级（p = < 0.0001）和≥ 2 次血管内治疗（p = 0.001），而年龄（p = 0.043）、RIC 等级（p = 0.结论 AVMs GKRS 术后并发症为潜伏期出血占 5.7%，症状性放射性坏死占 6.2%。年龄、RIC分级和≥2次血管内手术是症状性放射性坏死的风险因素。由于除GRKS外，血管内手术的益处尚不明确及其潜在的负面影响，因此应仔细权衡血管内治疗的适应症。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Complications after Gamma Knife Radiosurgery for Brain AVMs: Predictive factors for symptomatic radionecrosis

Purpose

The aim of this study is to investigate complications after Gamma Knife Radiosurgery (GKRS) for AVMs and predictive factors for symptomatic radionecrosis.

Methods

A retrospective single centre study on AVMs treated with GKRS between 2008 and 2016 was performed.

Results

A total of 209 patients were included. AVM obliteration was seen in 70%, while radiation induced changes (RIC) were detected in 45%. Symptomatic radionecrosis was found in 13 patients (6.2%). Furthermore, 12 patients (5.7%) experienced latent period haemorrhage. Predictors of symptomatic radionecrosis were 12 Gy volume (p = 0.007), RIC grade (p = < 0.0001) and ≥ 2 endovascular treatments (p = 0.001) in univariate analysis, while age (p = 0.043), RIC grade (p = 0.0002) and ≥ 2 endovascular procedures (p = 0.002) were identified in multivariate analysis.

Conclusion

Complication after GKRS for AVMs were latent period haemorrhage in 5.7% and symptomatic radionecrosis in 6.2%. Age, RIC grade and ≥ 2 endovascular procedures were risk factors for symptomatic radionecrosis. Due to the unclear benefits of endovascular procedures in addition to GRKS and its potential negative effects, the indication for endovascular treatment should be weighed carefully.

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来源期刊

Acta Neurochirurgica 医学-临床神经学

CiteScore

4.40

自引率

4.20%

发文量

342

审稿时长

1 months

期刊介绍： The journal "Acta Neurochirurgica" publishes only original papers useful both to research and clinical work. Papers should deal with clinical neurosurgery - diagnosis and diagnostic techniques, operative surgery and results, postoperative treatment - or with research work in neuroscience if the underlying questions or the results are of neurosurgical interest. Reports on congresses are given in brief accounts. As official organ of the European Association of Neurosurgical Societies the journal publishes all announcements of the E.A.N.S. and reports on the activities of its member societies. Only contributions written in English will be accepted.