Outcome of LINAC Radiosurgery for a Cavernous Angioma

Hong,  Semie; Chie,  Eui Kyu; Park,  Suk Won; Kim,  Il Han; Ha,  Sung Whan; Park,  Charn Il

J Korean Soc Ther Radiol Oncol > Volume 21(2); 2003 > Article

Original Article

The Journal of the Korean Society for Therapeutic Radiology and Oncology 2003;21(2): 107-111.

Outcome of LINAC Radiosurgery for a Cavernous Angioma

Semie Hong, Eui Kyu Chie, Suk Won Park, Il Han Kim, Sung Whan Ha, Charn Il Park

¹Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea. ihkim@snu.ac.kr
²Department of Radiation Oncology, College of Medicine, Hallym University, Korea.
³Institute of Radiation Medicine, Medical Research Center, Seoul National University, Korea.
⁴Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

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.

Key Words: Cavernous angioma, Stereotactic radiosurgery