Margin dose and AVM score influence obliteration and outcomes in BAVM GKRS

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The following is a summary of “Stereotactic radiosurgery alone for cerebral arteriovenous malformations: a single-institution experience,” published in the September 2024 issue of neurology by Zhu et al.

Researchers conducted a retrospective study examining the long-term outcomes of patients with brain arteriovenous malformations (BAVMs) treated exclusively with stereotactic radiosurgery (SRS).

201 patients with a diagnosis of BAVM were involved (January 2010 and December 2019). Multivariate analysis identified predictors of obliteration or bleeding, which were estimated using ORs and 95% CIs.

Results showed that 201 patients were treated with gamma knife radiosurgery (GKRS) as the primary intervention for BAVMs. The mean age at GKRS treatment was 31.4 ± 1.1 years, with 61.2% of patients being male. Multivariate logistic regression showed that a higher radiosurgery-based AVM score (OR 1.847, 95% CI = 1.292–2.641; P=0.001) was significantly correlated with worse obliteration outcomes, while a higher marginal dose improved obliteration rates (OR 0.352, 95% CI = 0.189–0.658; P=0.001). Furthermore, multivariate analysis revealed a 1 cm increase in lesion volume³ (OR 1.279, 95% CI = 1.023–1.600; P=0.031) and a high marginal dose (OR 0.363, 95% CI = 0.134–0.983; P=0.046) as significant prognostic factors for post-SRS bleeding.

The researchers concluded that higher margin dose was significantly associated with improved obliteration rate and non-hemorrhagic outcomes in patients with BAVM treated with SRS.

Source: bmcneurol.biomedcentral.com/articles/10.1186/s12883-024-03876-w