| Summary: | 碩士 === 淡江大學 === 數學學系 === 87 === Arteriovenous malformations (AVM) is one of the most common symptomatic vascular malformations of the central nervous system. It could exist since the patients’ childhood. The magnitude of the risk for hemorrhage from an untreated AVM is increasing with respect to age. The reported annual incidence of hemorrhage is 5%. The hemorrhage could cause neurological deficit. AVM may cause epileptic fits for untreated patients.
The conventional treatment for AVM is the neurosurgery. However, for some large AVM or those located in deep intracranial AVM, the risk of neurosurgery will increase tremendously. The application of Gamma knife stereotactic radiosurgery to treat AVM is relatively recent development. There are 216 AVM patients have been treated with Gamma Knife in Veterans General Hospital-Taipei from Mar. 1993 to Oct. 1997. In the last 2 years, they found that the treatments results for large AVM are also very promising. In the recent years, the treatment equipment and diagnostic tools (MRI/MRA) have significant improvement and/or the usage of computer package, named Gamma Plan, for dose planning and the decision of isocenters have increased the treatment effects of Gamma Knife to AVM patients.
The study purpose of this thesis is to evaluate the treatment effects of Gamma Knife for AVM patients by using the survival analysis. To evaluate the effects of prognostic factors on the inducing two major complications, named ARE(Aderse Radiation Effects) and Hemorrhage, of Gamma knife for AVM patients, we use the logistic regression method.
According to our study, we got the following results:
(1) The treatment effects: the size of AVM had significant effect on the complete obliteration (CO) rate. The larger the volume of AVM is , the lower the CO rate will be.
(2) The Complications: the size of AVM had significant effect on inducing ARE. And, the odds of inducing ARE is increasing wit respect to the tumor volume. Moreover, for those patients with pre-hemorrhage, the odds of inducing ARE is higher than those without. On the other hands, the size of AVM had significant positive effect on inducing post-hemorrhage. Again, the pre-hemorrhage will increase the odds of inducing hemorrhage .
|
|---|
