STEREOTAXIC RADIOSURGERY FOR ARTERIOVENOUS-MALFORMATIONS OF THE BRAINUSING A STANDARD LINEAR-ACCELERATOR - THE LYON EXPERIENCE

Radiosurgery (RS) was initiated in Lyon in October 1989. The technique was adapted from that described by Lutz and Saunders in Boston (BRW s tereotactic frame). Irradiation is delivered with Ig-MV photons produc ed by a LINAC. From December 1989 to December 1992, 41 patients with a rteriovenous malformations were treated by RS; the median age was 33 y ears. The largest lesion diameter was 11.2-38.5 mm. Fifteen to 20 Gy w ere delivered on the 70% isodose line. Angiography was performed at 2 years post-treatment in 32 patients demonstrating an overall complete thrombosis rate of 81.3%. This incidence was significantly correlated with the Spetzler and Martin grade before RS (P=0.0055). Two patients (4.9%) experienced haemorrhage after radiosurgical treatment and one d ied from an intracerebral-intraventricular haemorrhage. Four patients (9.7%) experienced permanent radiation-induced neurological complicati ons.