Change search
ReferencesLink to record
Permanent link

Direct link
Hypofractionated conformal stereotactic radiotherapy for arteriovenous malformations
Umeå University, Faculty of Medicine, Pharmacology and Clinical Neuroscience.
Show others and affiliations
2003 (English)In: Neurosurgery, ISSN 0148-396X, Vol. 53, no 5, 1036-1042 p.Article in journal (Refereed) Published
Place, publisher, year, edition, pages
2003. Vol. 53, no 5, 1036-1042 p.
URN: urn:nbn:se:umu:diva-5303DOI: 10.1227/01.NEU.0000088566.82699.E6OAI: diva2:144781
Available from: 2006-09-18 Created: 2006-09-18Bibliographically approved
In thesis
1. Hypofractionated conformal stereotactic radiotherapy in the treatment of AVMs and cerebral metastases
Open this publication in new window or tab >>Hypofractionated conformal stereotactic radiotherapy in the treatment of AVMs and cerebral metastases
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Hypofractionated conformal stereotactic radiotherapy (HCSRT) has been used for the treatment of AVMs at the Umeå University Hospital since 1986. From this year and onwards an increasing number of patients with single or oligo brain metastases have also been treated using this technique.

In paper I we have retrospectively evaluated our treatment results of AVMs in terms of obliteration and complications. The rates of obliteration and complications seem to be comparable with SRS even if the AVM volumes in our series were larger than in most series with SRS. In paper II we have retrospectively evaluated the results in terms of local control, survival and complications in two groups of patients with single or oligo brain metastases. One group was treated with HCSRT alone and the other group was treated with whole brain radiotherapy in combination with a stereotactic boost. Controversy still exists concerning the benefit of additional use of WBRT in combination with stereotactic irradiation. The survival times were equal in the two groups and no significant difference in local control was observed. The omission of WBRT seems to carry a higher risk for development new brain metastases distant from the irradiated area. In paper III we report the treatment results in a subgroup of AVMs treated with a combination of embolisation and HCSRT. We also focus on the reduction of vascular density within the nidus of an AVM and propose a method to digitally compare images and more objectively assess a reduction in vascular density following embolisation. Obliteration rates seem comparable with other series using a combination of SRS and embolisation even if our rate of complications was higher than what is usually reported. Using luminescence as measure of vascular density all AVMs seemed to be less dense after embolisation.

Treatment accuracy in terms of reproducibility of the isocenter in consecutive treatment sessions is crucial in fractionated radiotherapy. In paper IV we have radiologically evaluated the reproducibility of the isocenter in successive treatment sessions using the non invasive relocatable Fixster frame. There was a high degree of reproducibility and only small errors that most likely is of no clinical importance.

A reliable dose plan is equally important as a tool to predict the dose delivered inside and outside the target volume. In paper V we have evaluated the reliability of treatment plans in HCSRT for targets of different geometry and size. A liquid ion chamber and gel dosimeter was used for assessment of dose distribution and absorbed dose. The doseplanning system proved to be accurate in predicting the absorbed dose and dose distribution for the different targets.

91 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1042
arteriovenous malformations, brain metastases, hypofractionation, stereotactic radiotherapy, LINAC, embolisation
Research subject
Clinical Neurophysiology
urn:nbn:se:umu:diva-864 (URN)91-7264-135-5 (ISBN)
Public defence
2006-10-13, Sal B, plan 9, 1D, Tandläkarhögskolan, Umeå, 09:00 (English)
Available from: 2006-09-18 Created: 2006-09-18 Last updated: 2009-10-09Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text
By organisation
Pharmacology and Clinical Neuroscience
In the same journal

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 27 hits
ReferencesLink to record
Permanent link

Direct link