Efficacy and morbidity of arc-therapy radiosurgery for cerebral arteriovenous malformations: a comparison with the natural history

To report the results of arc-therapy radiosurgery for cerebral arteriovenous malformation (AVM) and to compare the adverse event rate with the rate expected from the natural history. We performed a retrospective study of our 118 first patients with a mean follow-up of 46 months (range, 5–105 months). The AVMs had features indicating a poor prognosis at initial presentation and had already been treated by previous embolizations in 88% of patients. The mean volume of the targets was 7.4 cm 3 (range, 0.3–28.3 cm 3). The mean minimal and maximal dose was 17.7 Gy (range, 10–25 Gy) and 24.5 Gy (range, 17–36 Gy), respectively. The crude and 5-year actuarial rate of cure (total obstruction of the AVM shunt at angiography) was 54% (60 of 112) and 77%, respectively. The only independent prognostic factor of cure was the AVM volume (crude cure rate 67% for