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10-12-2023 | Arteriovenous Malformation | Research

Hypofractionated stereotactic radiotherapy in Spetzler Martin grades 4 and 5 arteriovenous malformations in the pediatric population: Is it a viable alternative?

Authors: Jeena Joseph, Krishna Prabhu Raju, Gandham Edmond Jonathan, Rajesh B, Swaminathan Ganesh, Patricia S, Henry Finlay Godson

Published in: Child's Nervous System | Issue 4/2024

Abstract

Objective

To analyze the outcomes of hypofractionated stereotactic radiotherapy (HFSRT) for Spetzler Martin grades 4 and 5 arteriovenous malformations (AVMs) in a pediatric population.

Methods

Fourteen patients with Spetzler Martin (SM) grades IV and V large AVMs who underwent HFSRT between January 2013 and July 2019 were retrospectively reviewed. All patients received HFSRT at a dose of 30–36 Gy in 5 to 6 fractions. They were followed up annually with clinical and imaging assessments to evaluate obliteration rates.

Results

The median age at presentation was 15 years (range 8–21 years). Ten (71%) were SM grade 4 AVMs and the rest were SM grade 5 AVMs. The majority presented with headache (8 [57%]), and 3 (21%) presented with bleeding. The median nidus volume was 39.4 cc (IQR, 31.4–52.4). Two (14%) patients had infratentorial AVMs. All of them had deep venous drainage. The median clinical follow-up duration was 75 months (range 31–107 months). There was complete obliteration of the nidus in 3 (21%) patients with a median time to obliteration of 39 months. HFSRT resulted in a reduction of the AVM volume to 12 cc or less in nearly 70% of patients. None of the patients experienced re-bleeding. 79% reported an improvement in their symptoms.

Conclusion

HFSRT is a highly effective treatment for high-grade AVMs in children, which can result in either complete elimination or significant reduction of the nidus volume or make it suitable for additional treatment, such as single-session stereotactic radiosurgery (SRS).

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Title: Hypofractionated stereotactic radiotherapy in Spetzler Martin grades 4 and 5 arteriovenous malformations in the pediatric population: Is it a viable alternative?
Authors: Jeena Joseph
Krishna Prabhu Raju
Gandham Edmond Jonathan
Rajesh B
Swaminathan Ganesh
Patricia S
Henry Finlay Godson
Publication date: 10-12-2023
Publisher: Springer Berlin Heidelberg
Keywords: Arteriovenous Malformation
Radiotherapy
Published in: Child's Nervous System / Issue 4/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-023-06244-0

2024 ASCO Annual Meeting

Springer Medicine

Hypofractionated stereotactic radiotherapy in Spetzler Martin grades 4 and 5 arteriovenous malformations in the pediatric population: Is it a viable alternative?

Abstract

Objective

Methods

Results

Conclusion

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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