Nicolato Antonio, Lupidi Francesco, Sandri Marco F, Foroni Roberto, Zampieri Piergiuseppe, Mazza Carlo, Pasqualin Alberto, Beltramello Alberto, Gerosa Massimo
Department of Neurosurgery, University of Verona and University Hospital, Verona, Italy.
Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):914-21. doi: 10.1016/j.ijrobp.2005.09.013. Epub 2005 Dec 9.
To evaluate and compare obliteration rates (OBRs) and treatment-obliteration intervals (TOIs) for cerebral arteriovenous malformations (cAVMs) treated with Gamma Knife radiosurgery in children/adolescents and adults; and to determine factors predicting the OBR and TOI in these two populations.
This study concerned 62 children/adolescents and 193 adults observed for > or = 3 years. Fisher exact two-tailed and Wilcoxon rank-sum tests, multiple logistics, and Cox proportional hazard models were used for statistical analysis.
The overall OBR was 85.5% in children/adolescents and 87.6% in adults (p = 0.671), but children/adolescents showed higher 36-month actuarial OBRs (69.35%) and shorter median TOIs (25.7 months) than adults (66.84% and 28.2 months; p = 0.006 and p = 0.017, respectively). In children/adolescents, lower Spetzler-Martin grades (p = 0.043) and younger age (p = 0.019) correlated significantly with OBRs, and lower Spetzler-Martin grades (p = 0.024) and noneloquent cAVM locations (p = 0.046) with TOIs. In adults, low flow through the cAVM and < 6.2-cm3 volume were associated with both OBR and TOI (p = 0.012 and p = 0.002, respectively).
The differences in OBRs within 3 years and TOIs, although slight, seem to show that pediatric cAVMs behave differently from those in adults after Gamma Knife radiosurgery.
评估并比较儿童/青少年和成人接受伽玛刀放射外科治疗的脑动静脉畸形（cAVM）的闭塞率（OBR）和治疗至闭塞间隔时间（TOI）；并确定这两个人群中预测OBR和TOI的因素。
本研究涉及62名儿童/青少年和193名成年人，观察时间≥3年。采用Fisher精确双侧检验、Wilcoxon秩和检验、多元逻辑回归和Cox比例风险模型进行统计分析。
儿童/青少年的总体OBR为85.5%，成人为87.6%（p = 0.671），但儿童/青少年的36个月精算OBR（69.35%）高于成人（66.84%），中位TOI（25.7个月）短于成人（28.2个月；p分别为0.006和0.017）。在儿童/青少年中，较低的Spetzler-Martin分级（p = 0.043）和较年轻的年龄（p = 0.019）与OBR显著相关，较低的Spetzler-Martin分级（p = 0.024）和非功能区cAVM位置（p = 0.046）与TOI相关。在成人中，cAVM低血流量和体积<6.2 cm³与OBR和TOI均相关（p分别为0.012和0.002）。
3年内OBR和TOI的差异虽然微小，但似乎表明伽玛刀放射外科治疗后儿童cAVM的表现与成人不同。
