CoChat
Sign Up
Cited by 295Vascular Malformations Diagnosis and TreatmentRadiation Therapy and DosimetryVascular Malformations and Hemangiomas

The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.

Stereotactic Heavy-Charged-Particle Bragg-Peak Radiation for Intracranial Arteriovenous Malformations

Open access
Steinberg, Gary K., Fabrikant, Jacob I., Marks, Michael P., Levy, Richard P., Frankel, Kenneth A., Phillips, Mark H., Shuer, Lawrence M., Silverberg, Gerald D.·1990·New England Journal of Medicine
DOI 10.1056/nejm199007123230205
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND: Heavy-charged-particle radiation has several advantages over protons and photons for the treatment of intracranial lesions; it has an improved physical distribution of the dose deep in tissue, a small angle of lateral scattering, and a sharp distal falloff of the dose. METHODS: We present detailed clinical and radiologic follow-up in 86 patients with symptomatic but surgically inaccessible cerebral arteriovenous malformations that were treated with stereotactic helium-ion Bragg-peak radiation. The doses ranged from 8.8 to 34.6 Gy delivered to volumes of tissue of 0.3 to 70 cm3. RESULTS: Two years after radiation treatment, the rate of complete obliteration of the lesions, as detected angiographically, was 94 percent for lesions smaller than 4 cm3, 75 percent for those of 4 to 25 cm3, and 39 percent for those larger than 25 cm3. After three years, the rates of obliteration were 100, 95, and 70 percent, respectively. Major neurologic complications occurred in 10 patients (12 percent), of whom 8 had permanent deficits. All these complications occurred in the initial stage of the protocol, before the maximal dose of radiation was reduced to 19.2 Gy. In addition, hemorrhage occurred in 10 patients from residual malformations between 4 and 34 months after treatment. Seizures and headaches were less severe in 63 percent of the 35 and 68 percent of the 40 patients, respectively, who had them initially. CONCLUSIONS: Given the natural history of these inaccessible lesions and the high risks of surgery, we conclude that heavy-charged-particle radiation is an effective therapy for symptomatic, surgically inaccessible intracranial arteriovenous malformations. The current procedure has two disadvantages: a prolonged latency period before complete obliteration of the vascular lesion and a small risk of serious neurologic complications.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejm199007123230205

Cites

23 of 23 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 23 references

Research works printed but not linked: 3

  1. Kjellberg RN. Proton beam therapy for arteriovenous malformations of the brain. In: Schmidek HH, Sweet WH, eds. Operative neurosurgical techniques: indications, methods and results. 2nd ed. Vol. 2. Philadelphia: W.B. Saunders, 1988:911–5.
  2. 1989, Neurosurgery, 25, 670
  3. Stein BM. Surgical decisions in vascular malformations of the brain. In: Barnett HJM, Stein BM, Mohr JP, Yatsu FM, eds. Stroke: pathophysiology, diagnosis, and management. Vol. 2. New York: Churchill Livingstone, 1986:1129–72.

Cited by

Sorted by citations

Related

See all

Metadata

Authors
Steinberg, G. K., Fabrikant, J. I., Marks, M. P., Levy, R. P., Frankel, K. A., Phillips, M. H., Shuer, L. M., & Silverberg, G. D.
Affiliations
  • Stanford Medicine (US)
  • Lawrence Berkeley National Laboratory (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1990-07-12
Volume
323
Issue
2
Pages
96-101
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199007123230205
OpenAlex
W2037803738
Cited by
295
References
23
Citations by year
2025: 1 · 2024: 3 · 2022: 4 · 2020: 3 · 2018: 1 · 2016: 4 · 2015: 8 · 2014: 7 · 2013: 5 · 2012: 9
FWCI
17.10
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Vascular Malformations Diagnosis and Treatment
  • Physical Sciences › Physics and Astronomy › Radiation › Radiation Therapy and Dosimetry
  • Health Sciences › Medicine › Surgery › Vascular Malformations and Hemangiomas
Keywords
intracranial arteriovenous malformations, helium ion therapy, stereotactic radiotherapy, Bragg peak, neurological complications, hemorrhage, seizures, headache
MeSH terms
Adolescent, Adult, Aged, Cerebral Angiography, Intracranial Arteriovenous Malformations, Cerebral Hemorrhage, Child, Female, Follow-Up Studies, Helium, Humans, Male, Middle Aged, Radiotherapy, Radiotherapy Dosage

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review