Post-Radiation Reactions after Radiosurgery for Cavernous Malformations and Factors Influencing Their Frequency

Purpose : To investigate the structure of adverse post-radiation reactions occurring after radiosurgical treatment of cavernous malformations (CMs) and to identify factors influencing their frequency. Material and methods : Between September 2005 and September 2020, 123 patients with single CMs of the brain (a total of 123 CMs) were irradiated at the center. The final analysis included 67 patients. Dose distribution data were subjected to regression analysis. Results : Nineteen cases of post-radiation edema (28.3 %) and two cases of post-radiation necrosis (2.9 %) were identified. During the observation period, ten patients experienced hemorrhage from the irradiated CM (14.9 %). The dose received by 50 % of the target volume (including the planning target volume) was determined to be the most significant predictor of post-radiation edema development in patients after radiosurgery for single cavernomas. Conclusion : In cases of deep-seated CMs, microsurgical removal is associated with a high risk of complications. In such cases, radiosurgery can be offered as a safe alternative to microsurgery.