External Stereotactic Focal Irradiation of Arteriovenous Malformations by a Routinely Used Linear Accelerator

  • Hans-Bruno Makoski
Part of the Medical Radiology book series (MEDRAD)


The biological difference in radiosensitivity of cells within and outside the target volume plays an important part in radiotherapy, especially in malignant tumors. Fractionated doses are needed for the recovery of normal tissue. If the dose gradient is very steep at the edge of the target volume, a single dose sufficient to cause cell death may be given: radiosurgery. Stereotactic radiosurgery implies the application of well-collimated beams of ionizing radiation. It is of especial interest in the head for the treatment of malignant tumors or metastases (Sturm et al. 1987) or pituitary adenomas or vascular disorders like carotid-cavernous fistulas (Yasunaga et al. 1987) and arteriovenous malformations (Steiner et al. 1974, 1977).


Pituitary Adenoma Arteriovenous Malformation Linear Accelerator Stereotactic Radiosurgery Relative Biologic Effectiveness 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Drake CG (1983) Arteriovenous malformations of the brain. The options for management. N Engl J Med 309: 308–310PubMedCrossRefGoogle Scholar
  2. Fabrikant JI (1989) Workshop on radiosurgery. ISR-Congress, ParisGoogle Scholar
  3. Glanzmann C (1978) Zerebrale arteriovenöse MiBbildungen: Verlauf bei 18 Fällen nach Radiotherapie. Strahlentherapie 154: 305–308PubMedGoogle Scholar
  4. Graf CJ, Perret GE, Torner JC (1983) Bleeding from cerebral arteriovenous malformations as part of their natural history. J Neurosurg 58: 331–337PubMedCrossRefGoogle Scholar
  5. Hartmann GH, Schlegel W, Sturm V, Kober B, Pastyr O, Lorenz WJ (1985) Cerebral radiation surgery using moving field irradiation at a linear accelerator facility. Int J Radiat Oncol Biol Phys 11: 1185–1192PubMedCrossRefGoogle Scholar
  6. Johnson RT (1975) Radiotherapy of cerebral angiomas. In: Pia HW, Gleave JRW, Grote E, Zierski J (eds) Cerebral angiomas. Springer, Berlin Heidelberg New York, pp 256–259CrossRefGoogle Scholar
  7. Kimmig B, Engenhart R, Wowra B, Marin-Grez M, Sturm V, Höver KH (1988) Stereotaktisch gezielte Strahlentherapie zerebraler arteriovenöser GefäBmiBbildungen ( AVM ). Zentralbl Radiol 136: 639Google Scholar
  8. Kimmig B, Engenhart R, Höver KH, Wowra B, Schneider S, Wannenmacher M (1989) Radiosurgery for cerebral angiomas using a linear accelerator. Int J Radiat Oncol Biol Phys [Suppl 1] 17: 234–235CrossRefGoogle Scholar
  9. Kingsley DPE, Bergström M, Bergren B-M (1980) A critical evaluation of two methods of head fixation. Neuroradiology 19: 7–12PubMedGoogle Scholar
  10. Kjellberg RN (1986) Stereotactic Bragg peak proton beam radiosurgery for cerebral arteriovenous malformations. Ann Clin Res [Suppl 47] 18: 17–19Google Scholar
  11. Larson DA (1989) Radiosurgery. Refresher Course, ASTRO-Congress, San FranciscoGoogle Scholar
  12. Lutz W, Winston KR, Maleki N (1988) A system for stereotactic radiosurgery with a linear accelerator. Int J Radfiat Oncol Biol Phys 14: 373–381CrossRefGoogle Scholar
  13. Makoski H-B, Nocken U, Fiebach BJO, Zeilstra DJ (1984) Die Radiotherapie arteriovenöser Malformation des Hirnes. Strahlentherapie 160: 159–165PubMedGoogle Scholar
  14. Makoski H-B, Zeilstra DJ, Nocken U (1988) Arteriovenöse Malformationen des Hirnschädels — strahlentherapeutische Aspekte, In: Bamberg M, Sack H (eds) Therapie primärer Hirntumoren. Zuckschwerdt, Munich, pp 245–249Google Scholar
  15. Makoski H-B, Zeilstra DJ, Bettag W (1989) Die Strahlenbehandlung intrakranieller arteriovaskulärer Malformationen — Erfahrungen mit semi-stereotaktischer Technik. Radiobiol Radiother 30 (3): 213–220Google Scholar
  16. Mehdorn HM, Grote W (1988) Zur Strahlentherapie inoperabler arteriovenöser Gefäßmißbildungen. In: Bamberg M, Sack H (eds) Therapie primärer Hirntumoren. Zuckschwerdt, Munich, pp 250–255Google Scholar
  17. Nocken U, Ewen K, Makoski H-B (1983) Somatisches Strahlenrisiko bei Hirnbestrahlungen. Strahlentherapie 159: 548–550PubMedGoogle Scholar
  18. Podgorsak EB, Olivier A, Pla M, Lefebvre P-Y, Hazel J (1988) Dynamic stereotactic radiosurgery. Int J Radiat Oncol Biol Phys 14: 115–126PubMedCrossRefGoogle Scholar
  19. Poulsen MG (1987) Arteriovenous malformations: a summary of 6 cases treated with radiation therapy. Int J Radiat Oncol Biol Phys 13: 1553–1557PubMedCrossRefGoogle Scholar
  20. Saunders WM, Winston KR, Siddon RL, Svensson GH, Kijewski PK, Rice RK, Hansen JL, Barth NH (1988) Radiosurgery of arter ovenous malformations of the brain using a standard linear accelerator: rationale and technique. Int J Radiation Oncology Biol Phys 15: 441–447CrossRefGoogle Scholar
  21. Sheline GE, Wara WM, Smith V (1980) Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys 6: 1215–1228PubMedCrossRefGoogle Scholar
  22. Steiner L, Leksell L, Greitz T, Forster DMC, Backlund EO (1972) Stereotaxic radiosurgery for cerebral arteriovenous malformations. Acta Chir Scand 138 (1972): 459–464PubMedGoogle Scholar
  23. Steiner L (1984) Treatment of arteriovenous malformations by radiosurgery. In: Wilson CB, Stein BM (eds) Intracranial arteriovenous malformations. Williams and Wilkins, Baltimore, pp 295–314Google Scholar
  24. Steiner L, Leksell L, Forster DMC, Greitz T, Backlund EO (1974) Stereotactic radiosurgery in intracranial arterio-venous malformations. Acta Neurochir [Suppl] (Wien) 21: 195–209Google Scholar
  25. Steiner L, Backlund E-O, Greitz T, Leksell L, Noren G, Rähn T (1977) Radiosurgery in intracranial arteriovenous malformations. Excerpta Med Int Congr Ser 433: 168–180Google Scholar
  26. Sturm V, Kober B, Höver K-H, Schlegel W, Boesecke R, Pastyr O, Hartmann GH, Schabbert S, zum Winkel K, Kunze S, Lorenz WJ (1987) Stereotactic percutaneous single dose irradiation with a linear accelerator. Int J Radiat Oncol Biol Phys 13: 279–282PubMedCrossRefGoogle Scholar
  27. Sutton ML (1984) Adult central nervous system. In: Easson EC, Pointon RCS (eds) The radiotherapy of malignant disease. Springer, Berlin Heidelberg New York, pp 225–227Google Scholar
  28. Tognetti F, Andreoli A, Cuscini A, Testa C (1985) Successful management of an intracranial arteriovenous malformation by conventional irradiation. J Neurosurg 63: 193–195PubMedCrossRefGoogle Scholar
  29. Wolkov HB, Bagshaw MA (1988) Conventional radiation therapy in the management of arteriovenous malformations of the central nervous system. Int J Radiat Oncol Biol Phys 15: 1461–1464PubMedCrossRefGoogle Scholar
  30. Yasunaga T, Takada C, Uozumi H, Saito Y, Uena S, Hatanaka Y, Baba Y, Takahashi M (1987) Radiotherapy of spontaneous carotid-cavernous sinus fistulas. Int J Radiat Oncol Biol Phys 13: 1909–1913PubMedCrossRefGoogle Scholar
  31. Zeilstra DJ, Bettag W, Makoski H-B (1986) Radiotherapy of intracranial AVM’s. J Neurosurg 64: 525PubMedGoogle Scholar
  32. Zeilstra DJ (1987) Semi-stereotaktische Bestrahlung inoperabler arteriovenöser Mißbildungen des Hirns. Thesis, University of CologneGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • Hans-Bruno Makoski
    • 1
  1. 1.Strahlenklinik — Radioonkologie — NuklearmedizinStädtische Kliniken DuisburgDuisburg 1Germany

Personalised recommendations