5 research outputs found
Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain
Background: The goal of treatment in arteriovenous malformation (AVM)
is total obliteration of the AVM, restoration of normal cerebral
function, and preservation of life and neurological function. Aim: To
analyze the results of X-knife and surgery for AVM of the brain. The
endpoints for success or failure were as follows: success was defined
as angiographic obliteration and failure as residual lesion, requiring
retreatment, or death due to hemorrhage from the AVM. Materials and
Methods: From May 2002 to May 2007, 54 patients were enrolled for this
study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%,
grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated
by microsurgical resection out of which Grade I was seen in 5 patients,
Grade II was seen in 17 patients, Grade III was seen in 9 patients and
Grade V was seen in 7 patients. Rest of the sixteen patients were
treated by linear accelerator radiosurgery out of which Grade II was
seen in 6 patients, Grade III was seen in 5 patients and Grade IV was
seen in 5 patients. The follow up was in range of 3-63 months. In
follow up, digital subtraction angiography/ magnetic resonance
angiography (DSA/MRA) was performed 3 months after surgery and 1 year
and 2 years after stereotactic radiosurgery (SRS). Results: Among the
patients treated with X-knife, 12/16 (75%) had proven angiographic
obliteration. Complications were seen in 4/16 (25%) patients. Among the
patients treated with microsurgical resection, 23/38 (61%) had proven
angiographic obliteration. Complications (both intraoperative and
postoperative) were seen in 19/38 (50%) patients. Conclusions:
Sixty-one percent of patients were candidates for surgical resection.
X-knife is a good modality of treatment for a low-grade AVM situated in
eloquent areas of the brain and also for high-grade AVMs, when the
surgical risk and morbidity is high
Analysis of X-knife and surgery in treatment of arteriovenous malformation of brain
Background: The goal of treatment in arteriovenous malformation (AVM)
is total obliteration of the AVM, restoration of normal cerebral
function, and preservation of life and neurological function. Aim: To
analyze the results of X-knife and surgery for AVM of the brain. The
endpoints for success or failure were as follows: success was defined
as angiographic obliteration and failure as residual lesion, requiring
retreatment, or death due to hemorrhage from the AVM. Materials and
Methods: From May 2002 to May 2007, 54 patients were enrolled for this
study. Grade I AVM was seen in 9%, grade II in 43%, grade III in 26%,
grade IV in 9%, and grade V in 13%. Thirty-eight patients were treated
by microsurgical resection out of which Grade I was seen in 5 patients,
Grade II was seen in 17 patients, Grade III was seen in 9 patients and
Grade V was seen in 7 patients. Rest of the sixteen patients were
treated by linear accelerator radiosurgery out of which Grade II was
seen in 6 patients, Grade III was seen in 5 patients and Grade IV was
seen in 5 patients. The follow up was in range of 3-63 months. In
follow up, digital subtraction angiography/ magnetic resonance
angiography (DSA/MRA) was performed 3 months after surgery and 1 year
and 2 years after stereotactic radiosurgery (SRS). Results: Among the
patients treated with X-knife, 12/16 (75%) had proven angiographic
obliteration. Complications were seen in 4/16 (25%) patients. Among the
patients treated with microsurgical resection, 23/38 (61%) had proven
angiographic obliteration. Complications (both intraoperative and
postoperative) were seen in 19/38 (50%) patients. Conclusions:
Sixty-one percent of patients were candidates for surgical resection.
X-knife is a good modality of treatment for a low-grade AVM situated in
eloquent areas of the brain and also for high-grade AVMs, when the
surgical risk and morbidity is high
Technical Report - Retrospective analysis of role of interstitial brachytherapy using template (MUPIT) in locally advanced gynecological malignancies
Aim : The aim of this retrospective study was to assess treatment
outcomes for patients with locally advanced gynecological malignancies
being treated with interstitial brachytherapy using Martinez universal
perineal interstitial template (MUPIT) and to study the acute and late
sequelae and survival after treatment by this technique. Materials and
Methods : Ninety seven patients untreated with histopathological
confirmation of carcinoma of cervix (37) vault (40) and vagina (20)
were treated by combination of external beam RT (EBRT) using
megavoltage irradiation to pelvis to dose of 4000-5000 cGy followed by
interstitial brachytherapy using MUPIT between September 2001 to March
2005. Median age was 46 years. Only those patients who were found
unsuitable for conventional brachytherapy or in whom intracavitatory
radiotherapy was found to be unlikely to encompass a proper dose
distribution were treated by interstitial template brachytherapy using
MUPIT application and were enrolled in this study. The dose of MUPIT
was 1600-2400 cGy in 4-6# with 400 cGy /# and two fractions a day with
minimum gap of six hours in between two fractions on micro-HDR.
Criteria for inclusion of patients were as follows: Hb minimum 10
gm/dl, performance status - 70% or more (Karnofsy scale),
histopathological confirmation FIGO stage IIB-IIIB (excluding frozen
pelvis). Results : Among the 97 patients studied, 12 patients lost to
follow-up and hence they were excluded from the study. Follow-up of
rest of the patients was then done up to September 2006. The duration
of follow-up was in the range of 20-60 months. Parameters studied were
local control rate, complication rate, mortality rate and number of
patients developing systemic metastasis. Local control was achieved in
56/85 (64.7%) and complication rate was 15/85 (17.6%). Local control
was better for nonbulky tumors compared bulky tumors irrespective of
stage of disease. Local control was better in patients with good
regression of disease after external beam radiotherapy. Time of gap
between EBRT and implant also had an impact on the outcome. Conclusion
: Interstitial template brachytherapy by MUPIT is a good alternative to
deliver high dose radiation in locally advanced gynecological
malignancies where conventional brachytherapy application is either not
feasible or likely to give optimal dose distribution. Loco regional
control obtained is definitely better than EBRT alone and within the
accepted range of complications
Technical Report - Retrospective analysis of role of interstitial brachytherapy using template (MUPIT) in locally advanced gynecological malignancies
Aim : The aim of this retrospective study was to assess treatment
outcomes for patients with locally advanced gynecological malignancies
being treated with interstitial brachytherapy using Martinez universal
perineal interstitial template (MUPIT) and to study the acute and late
sequelae and survival after treatment by this technique. Materials and
Methods : Ninety seven patients untreated with histopathological
confirmation of carcinoma of cervix (37) vault (40) and vagina (20)
were treated by combination of external beam RT (EBRT) using
megavoltage irradiation to pelvis to dose of 4000-5000 cGy followed by
interstitial brachytherapy using MUPIT between September 2001 to March
2005. Median age was 46 years. Only those patients who were found
unsuitable for conventional brachytherapy or in whom intracavitatory
radiotherapy was found to be unlikely to encompass a proper dose
distribution were treated by interstitial template brachytherapy using
MUPIT application and were enrolled in this study. The dose of MUPIT
was 1600-2400 cGy in 4-6# with 400 cGy /# and two fractions a day with
minimum gap of six hours in between two fractions on micro-HDR.
Criteria for inclusion of patients were as follows: Hb minimum 10
gm/dl, performance status - 70% or more (Karnofsy scale),
histopathological confirmation FIGO stage IIB-IIIB (excluding frozen
pelvis). Results : Among the 97 patients studied, 12 patients lost to
follow-up and hence they were excluded from the study. Follow-up of
rest of the patients was then done up to September 2006. The duration
of follow-up was in the range of 20-60 months. Parameters studied were
local control rate, complication rate, mortality rate and number of
patients developing systemic metastasis. Local control was achieved in
56/85 (64.7%) and complication rate was 15/85 (17.6%). Local control
was better for nonbulky tumors compared bulky tumors irrespective of
stage of disease. Local control was better in patients with good
regression of disease after external beam radiotherapy. Time of gap
between EBRT and implant also had an impact on the outcome. Conclusion
: Interstitial template brachytherapy by MUPIT is a good alternative to
deliver high dose radiation in locally advanced gynecological
malignancies where conventional brachytherapy application is either not
feasible or likely to give optimal dose distribution. Loco regional
control obtained is definitely better than EBRT alone and within the
accepted range of complications