[The influence of radiation doses on the results of radiosurgery of brain arteriovenous malformations].
Stereotactic radiosurgery as a method of treatment of inoperable brain angiomas has been in use in the Neurosurgery Department, Medical Academy in Lublin since 1990. The patients receive radiation from a Neptune 10P linear accelerator of 9 MeV photon energy (X radiation). The Laitinen stereoadapter used by us makes possible precise targeting and radiation application in time suitable for the patient and the whole treatment team. This frame produces no disturbances of CT image and is not covering the target. Non-invasive head immobilization in the frame is highly stable, although it requires good communication with the patient and his full cooperation. The purpose of the study was a comparison of the results of radiosurgery applied in the treatment of inoperable brain angiomas of various size with radiation doses 4000 cGy and 3000 cGy. The material comprises 40 first cases out of over 120 patients treated in this way for inoperable angiomas. The first group of 20 patients received 4000 cGy and the second group of 20 patients received 3000 cGy doses. Complete obliteration of angiomas was achieved in 16 (80%) cases treated with the 4000 cGy dose, and in 17 (85%) cases treated with the 3000 cGy dose. Late postradiation reactions developed in 15 (75%) patients in the first group with permanent changes in 5 (25%) patients. In the second group late postradiation reactions developed in only 6 (30%) cases and regressed in all. Treatment effectiveness (complete obliteration) after doses of 3000 and 4000 cGy was similar, and it decreased with greater size of angiomas. The per cent of postradiation complications after lower doses was much smaller, and permanent neurological changes were seen only after higher doses. The obtained results of the method are comparable with those of the authors using invasive methods of fixation of stereotactic frames.
Markiewicz
P
P
Kliniki Neurochirurgii i Neurochirurgii Dzieciecej AM w Lublinie.
Trojanowski
T
T
Gabczyński
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011829:Radiation Dosage; D016634:Radiosurgery / Q000295:instrumentation; D012720:Severity of Illness Index