Awad, A., Alomair, A., Rizwanullah, M., Alhebshi, A., Taha, A., Alzorkany, F., Alkafi, M., Phattacharya, J., Elashwah, A. (2024). The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience. Research in Oncology, 20(1), 1-8. doi: 10.21608/resoncol.2024.258069.1204
Ahmed A. Awad; Ameen S. Alomair; Mohammed M. Rizwanullah; Adnan S. Alhebshi; Amr Taha; Faisal S. Alzorkany; Mohammed A. Alkafi; Joti Phattacharya; Ahmed M. Elashwah. "The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience". Research in Oncology, 20, 1, 2024, 1-8. doi: 10.21608/resoncol.2024.258069.1204
Awad, A., Alomair, A., Rizwanullah, M., Alhebshi, A., Taha, A., Alzorkany, F., Alkafi, M., Phattacharya, J., Elashwah, A. (2024). 'The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience', Research in Oncology, 20(1), pp. 1-8. doi: 10.21608/resoncol.2024.258069.1204
Awad, A., Alomair, A., Rizwanullah, M., Alhebshi, A., Taha, A., Alzorkany, F., Alkafi, M., Phattacharya, J., Elashwah, A. The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience. Research in Oncology, 2024; 20(1): 1-8. doi: 10.21608/resoncol.2024.258069.1204
The Outcome of Patients with Cerebral Arteriovenous Malformations (AVMs) Treated with Stereotactic Radiosurgery (SRS) Using the CyberKnife (Rationale, Benefits and Risks): A Real-World Experience
1Section of Radiation Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
2Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt
3Radiation Oncology Department, Johns Hopkins Aramco Health Care, Dhahran, Saudi Arabia
4Radiation Oncology Department, King Fahad Specialist Hospital, Buraydah, Saudi Arabia
5Biomedical Physics Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
6Intervention Radiology Department, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
7Department of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy Faculty of Medicine, Cairo University, Cairo, Egypt
Abstract
Background: Cerebral arteriovenous malformations (AVMs) are complex, heterogeneous, uncommon lesions that carry a high risk of intracranial hemorrhage with subsequent disability. Aim: To evaluate the outcome of patients with cerebral AVMs treated in our center, King Faisal Specialized Hospital and Research Center (KFSH&RC) Saudi Arabia with SRS using the CyberKnife. Methods: Medical records of patients treated in the above-mentioned way in the period between 2009-2021 were retrospectively evaluated. Results: A total of 51 patients were included in this study. The median age at diagnosis was 31 (3-77) years. Neurological alteration and intracranial hemorrhage were the most common presentations in 24 (47.1%) patients. The mean maximum AVM nidus diameter and volume were 2.9 cm and 5.9 cc respectively. All the patients received SRS using CyberKnife with a median marginal dose of 20 (14-21) Gy over a single fraction. Volume staged treatment was applied in 4 (7.8%) patients. After a median follow-up of 37 (2-170) months, all patients were alive with successful obliteration of the AVM nidus occurring in 31 (60.8%) patients after a median latency period of 27 (4-68.9) months in those who achieved complete obliteration. No patients developed post-SRS hemorrhage and 11 (21.6%) patients developed post-SRS radiological radiation-induced changes of which only 3 (27.3%) patients were symptomatic (in the form of uncontrolled seizures). only SRS dose > 19 Gy was significantly correlated with the obliteration rate, as 79.3% of patients who received SRS dose > 19 Gy achieved obliteration vs 36.4 % only in those who received dose Conclusion: SRS treatment using CyberKnife is effective management for patients with cerebral AVMs without an increase in the incidence of post-SRS hemorrhage, stroke, or death.
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