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Vol. 40, No. 5, 2004
Issue release date: September–October 2004
Section title: Original Paper
Pediatr Neurosurg 2004;40:207–214
(DOI:10.1159/000082293)

Treatment of Pediatric Intracranial Arteriovenous Malformations with Linear-Accelerator-Based Stereotactic Radiosurgery: The University of Pennsylvania Experience

Maity A. · Shu H.-K.G. · Tan J.E. · Ruffer J. · Sutton L.N. · Tochner Z. · Lustig R.
aDepartment of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pa., bDepartment of Radiation Oncology, Albany Medical Center, Albany, N.Y., cGood Shepherd Radiation Oncology Center, Barrington, Ill., and dDepartment of Neurosurgery, Children’s Hospital of Philadelphia, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/28/2004
Accepted: 8/2/2004
Published online: 1/21/2005

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: http://www.karger.com/PNE

Abstract

There are relatively few reports detailing the outcome of children and adolescents with arteriovenous malformations (AVMs) treated with stereotactic radiosurgery (SRS). We reviewed our experience over the past decade to determine whether the outcomes and toxicity were similar to those reported in adults. Seventeen patients 18 years of age or younger underwent linear-accelerator-based SRS. The targeted volume was greater than 3 cm3 in 65% of cases (range 0.7–25 cm3; median volume 6.9 cm3). The prescribed radiation doses varied from 16 to 18 Gy, with 70% receiving the highest dose. Using only angiographic data, the obliteration rate was 80% (8 of 10 patients), but using both MRA/MRI and angiographic data, it was 53% (9 of 17 patients). Four patients developed late effects potentially attributable to the radiation between 2 months and 3 years following SRS. One of these was transient and disappeared completely within a few days, but in the other 3 patients, the neurologic sequelae were permanent. Two of the 4 complications appeared to be due to radiation necrosis/edema, whereas the remaining 2 may have been due to vasculopathy. All 4 patients with complications had treatment volumes greater than 5 cm3 (5.4, 6.9, 11.1, 16.4 cm3), all had a prescribed dose of 18 Gy and all had initially presented with an AVM hemorrhage. Linear-accelerator-based SRS is effective in obliterating most AVMs in children; however, the potential for late effects exists, especially for those patients with larger target volumes.


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 4/28/2004
Accepted: 8/2/2004
Published online: 1/21/2005

Number of Print Pages: 8
Number of Figures: 2
Number of Tables: 2

ISSN: 1016-2291 (Print)
eISSN: 1423-0305 (Online)

For additional information: http://www.karger.com/PNE


Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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