title: Stereotactic radiosurgery for arteriovenous malformations of the brain using a standard linear accelerator: the Lyon experience.
abstract: Radiosurgery (RS) was initiated in Lyon in October 1989. The technique was adapted from that described by Lutz and Saunders in Boston (BRW stereotactic frame). Irradiation is delivered with 18-MV photons produced by a LINAC. From December 1989 to December 1992, 41 patients with arteriovenous malformations were treated by RS; the median age was 33 years. The largest lesion diameter was 11.2-38.5 mm. Fifteen to 20 Gy were delivered on the 70% isodose line. Angiography was performed at 2 years post-treatment in 32 patients demonstrating an overall complete thrombosis rate of 81.3%. This incidence was significantly correlated with the Spetzler and Martin grade before RS (P = 0.0055). Two patients (4.9%) experienced haemorrhage after radiosurgical treatment and one died from an intracerebral-intraventricular haemorrhage. Four patients (9.7%) experienced permanent radiation-induced neurological complications.
authors.affiliation: Service de Radiothérapie-Oncologie Centre Hospitalier, Lyon Sud, France.
authors.forename: A
authors.initials: A
authors.lastname: Pica
authors.forename: L
authors.initials: L
authors.lastname: Ayzac
authors.forename: I
authors.initials: I
authors.lastname: Sentenac
authors.forename: F P
authors.initials: FP
authors.lastname: Rocher
authors.forename: I
authors.initials: I
authors.lastname: Pelissou-Guyotat
authors.forename: J C
authors.initials: JC
authors.lastname: Emery
authors.forename: R
authors.initials: R
authors.lastname: Deruty
authors.forename: C
authors.initials: C
authors.lastname: Lapras
authors.forename: P
authors.initials: P
authors.lastname: Bret
authors.forename: G
authors.initials: G
authors.lastname: Fischer
authors.forename: R
authors.initials: R
authors.lastname: Coquard
authors.forename: P
authors.initials: P
authors.lastname: Romestaing
authors.forename: J P
authors.initials: JP
authors.lastname: Gerard
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D016634:Radiosurgery / Q000295:instrumentation*; D013997:Time Factors; D016896:Treatment Outcome