Outcome of LINAC Radiosurgery for a Cavernous Angioma / 대한방사선종양학회지

ABSTRACT

PURPOSE: To establish the role of stereotactic radiosurgery using a linear accelerator for the treatment of patients with cavernous angioma. MATERIALS AND METHODS: Between February 1995 and May 1997, 11 patients with cavernous angioma were treated with stereotactic radiosurgery using a linear accelerator. Diagnoses were based on the magnetic resonance imaging in 8 patients, and the histological in 3. The vascular lesions were located in the brainstem (5 cases), cerebellum (2 cases) thalamus (1 case) and cerebrum (3 cases). The clinical presentation at onset included previous intracerebral hemorrhages (9 cases) and seizures (2 cases). All patients were treated with a a linac-based radiosurgery. The median dose of radiation delivered was 16 Gy ranging from 14 to 24 Gy, which was typically prescribed to the 80% isodose surface (range 50~80%), corresponding to the periphery of the lesion with a single isocenter. Ten patients were followed-up. RESULTS: The median follow-up was 49 months ranging from 8 to 73 months, during which time two patients developed an intracerebral hemorrhage, 1 at 8 months, with the other at 64 months post radiosurgery. One patient developed neurological deficit after radiosurgery, and two developed an edema on the T2 weighted images of the MRI surrounding the radiosurgical target. CONCLUSION: The use of stereotactic radiosurgery in the treatment of a cavernous angioma may be effective in the prevention of rebleeding, and can be safely delivered. However, a longer follow-up period will be required.