Evidence map›Paper›PMID 39472707›Full record

ArticleScientific reports2024

Stereotactic radiosurgery (SRS) for patients with brainstem cerebral cavernous malformations (CCMs): an international, multicentric study.

Sam Dayawansa, Chloe Dumot, Georgios Mantziaris, Zhiyuan Xu, Stylianos Pikis, Selcuk Peker, Yavuz Samanci, Gokce D Ardor, Ahmed M Nabeel, Wael A Reda and 26 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Scientific reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

36 authors.

Sam DayawansaDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA. samwansa20@gmail.com.
Chloe DumotDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Georgios MantziarisDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Zhiyuan XuDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Stylianos PikisDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.
Selcuk PekerDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Yavuz SamanciDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Gokce D ArdorDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Ahmed M NabeelGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Wael A RedaGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Sameh R TawadrosGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Khaled AbdelkarimGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Amr M N El-ShehabyGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Reem M Emad EldinGamma Knife Center Cairo, Nasser Institute Hospital, Cairo, Egypt.
Ahmed H ElazzaziExtended Modular Program- Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Nuria Martínez MorenoDepartment of Radiosurgery, Rúber Internacional Hospital, Madrid, Spain.
Roberto Martínez ÁlvarezDepartment of Radiosurgery, Rúber Internacional Hospital, Madrid, Spain.
Roman LiscakDepartment of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
Jaromir MayDepartment of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czech Republic.
David MathieuDivision of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, QC, Canada.
Jean-Nicolas TourignyDivision of Neurosurgery, Université de Sherbrooke, Centre de Recherche du CHUS, Sherbrooke, QC, Canada.
Manjul TripathiDepartment of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Akshay RajputDepartment of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Narendra KumarDepartment of Radiation Therapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Rupinder KaurDepartment of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Piero PicozziDepartment of Neurosurgery, Scientific Institute for Research, Hospitalization and Healthcare - IRCCS Humanitas Research Hospital, Milan, Italy.
Andrea FranziniDepartment of Neurosurgery, Scientific Institute for Research, Hospitalization and Healthcare - IRCCS Humanitas Research Hospital, Milan, Italy.
Herwin SpeckterDominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.
Wenceslao HernandezDominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.
Anderson BritoDominican Gamma Knife Center and Radiology Department, CEDIMAT, Santo Domingo, Dominican Republic.
Ronald E WarnickGamma Knife Center, Jewish Hospital, Mayfield Clinic, Cincinnati, OH, USA.
Juan AlzateDepartment of Neurosurgery, NYU Langone, New York City, NY, USA.
Douglas KondziolkaDepartment of Neurosurgery, NYU Langone, New York City, NY, USA.
Greg N BowdenDepartment of Neurosurgery and Department of Oncology, University of Alberta, Edmonton, AB, Canada.
Samir PatelDivision of Radiation Oncology, Department of Oncology, University of Alberta, Edmonton, AB, Canada.
Jason P SheehanDepartment of Neurological Surgery, University of Virginia, Box 800212, Charlottesville, VA, 22908, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Brainstem cerebral cavernous malformations (CCM) are clinically more aggressive compared to superficial CCMs. Due to their location, resection can be challenging, making stereotactic radiosurgery (SRS) an attractive alternative for symptomatic patient. Brainstem CCM patients (n = 170) were treated with Gamma Knife SRS at 11 radiosurgical centers. Hemorrhagic risk reduction, risk factors of post-SRS hemorrhage, and clinical outcomes were retrospectively analyzed. Most patients had a single (165/170 patients) brainstem CCMs treated; the majority of CCMs (165/181) presented with bleeding. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM (HR: 0.17, p < 0.001) using recurrent multivariate analysis. The annual hemorrhage rate decreased from 14.8 per 100 CCM-years before SRS to 2.3 after treatment. Using univariate Cox-analysis, the probability of a new hemorrhages after SRS was reduced for patient older than 35 years (HR = 0.21, p = 0.002) and increased with a margin dose > 13 Gy (HR = 2.57, p = 0.044). Adverse radiation effect (ARE) occurred in 9 patients (5.3%) and was symptomatic in four (2.4%). At a median follow-up of 3.4 years (Inter-quartile range: 5.4), 13 patients (8.0%) had a worsened clinical status, with the treated CCM being the cause in 5.6% (10) of the patients. Single-session SRS decreased the risk of repeat hemorrhage in patients with hemorrhagic brainstem CCM and conveyed this benefit with a low risk of advrse radiation effects (ARE) and worsening clinical status.

Indexed as

Brain StemHemangioma, Cavernous, Central Nervous SystemRadiosurgeryAdolescentAdultAgedBrain Stem NeoplasmsChildChild, PreschoolFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsTreatment OutcomebrainstemCerebral cavernous malformationHemorrhagicStereotactic radiosurgery

Identifiers

PMID39472707
PMCPMC11522693

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.