Malformaciones arteriovenosas intracraneales y radiocirugía con LINAC: artículo de revisión
Intracranial arteriovenous malformations and radiosurgery with LINAC: review article
S. Moreno-Jiménez
, M.A. Celis-López, L. Herrera-Gómez
Neurocirugía. Unidad de Radioneurocirugía. Instituto Nacional de Neurología y Neurocirugía MVS. México
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"apellidos" => "Suárez-Campos" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "García-Garduño" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Hernández-Bojórquez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Física Médica. Unidad de Radioneurocirugía. Instituto Nacional de Neurología y Neurocirugía MVS. México" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Radio-oncología. Unidad de Radioneurocirugía. Instituto Nacional de Neurología y Neurocirugía MVS. México" "etiqueta" => "<span class="elsevierStyleSup">**</span>" "identificador" => "aff0015" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intracranial arteriovenous malformations and radiosurgery with LINAC: review article" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-08-19" "fechaAceptado" => "2005-11-10" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec159331" "palabras" => array:4 [ 0 => "Malformaciones arteriovenosas" 1 => "Radiocirugía" 2 => "Terapia conformada" 3 => "LINAC" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec159332" "palabras" => array:4 [ 0 => "Arteriovenous malformations" 1 => "Radiosurgery" 2 => "Conformality" 3 => "LINAC" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">De las malformaciones vasculares, las malformaciones arteriovenosas (MAV) intracraneales son las que tienen una mayor repercusión desde el punto de vista clínico. Se pueden manifestar con hemorragia, epilepsia, cefalea, o pueden aparecer en forma incidental durante el abordaje diagnóstico de pacientes con traumatismos o cefalea crónica. Existen tres tipos de tratamientos disponibles: microcirugía, embolización y radiocirugía. El papel actual de la terapia endovascular es como adyuvante como tratamiento previo a microcirugía o a radiocirugía para disminuir el tamaño del nido. La meta final de cualquier tratamiento es la obliteración completa del nido sin causar un nuevo déficit neurológico. El índice general de obliteración por radiocirugía con LINAC es alrededor de 80% y es dependiente de la dosis, del volumen y del tiempo de seguimiento. La dosis promedio publicada en la literatura va de 15 a 25 Gy y la curva de isodosis para conformar la MAV con LINAC es por lo general la del 80%. Puede haber fallo en el tratamiento definido como la necesidad de volver a tratar al paciente después de tres años de seguimiento por falta de obliteración en alrededor del 26% de los pacientes.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Faltan pruebas principalmente a partir de ensayos clínicos, para seguir definiendo el papel de cada una de las modalidades en el tratamiento integral de las MAV.</p>" ] "en" => array:2 [ "titulo" => "Summary" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Among all vascular malformations, the intracranial arteriovenous malformations (AVM's) have the most powerful impact from the clinical point of view. The manifestations include hemorrhage, seizures, headacheh, but sometimes they are incidentally found during the diagnostic approach of patients with head trauma or chronic headache. There are three different types of treatments: microsurgery, endovascular treatment and radiosurgery. The actual role of the endovascular treatment is as an adjuvant therapy before microsurgery or radiosurgery just to diminish the nidus size. The goal of all treatments is complete nidus obliteration without causing a new neurological deficit. The overall obliteration index with LINAC based radiosurgery is about 80% and the result is dose, volume and time dependent. The mean dose reported in the literature fluctuates between 15 and 25 Gy, and the isodose coverage curve for the AVM with LINAC is generally the one of the 80%. There can be a treatment failure defined as the necessity to retreat the patient after three years from the first radiosurgical treatment in about 26% of the patients. There is a lack of evidence, principally from randomized trials, to point out the role of each of the modalities in the treatment of the AVM</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Moreno-Jiménez, S.; Celis-López, M.A.; Lárraga-Gutiérrez, J.M.; Herrera-Gómez, L.; Suárez-Campos, J.J.; García- Garduño, A.; Hernández-Bojórquez, M.: Malformaciones arteriovenosas intracraneales y radiocirugía con LINAC: artículo de revisión. Neurocirugía 2006; 17: 317–324.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:31 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toward an Expanded View of Radiosurgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.R. Adler" 1 => "F. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 0 | 3 | 3 |
| 2018 Febrero | 10 | 5 | 15 |
| 2018 Enero | 16 | 3 | 19 |
| 2017 Diciembre | 16 | 9 | 25 |
| 2017 Noviembre | 39 | 11 | 50 |
| 2017 Octubre | 9 | 7 | 16 |
| 2017 Septiembre | 12 | 9 | 21 |
| 2017 Agosto | 14 | 6 | 20 |
| 2017 Julio | 11 | 7 | 18 |
| 2017 Junio | 22 | 6 | 28 |
| 2017 Mayo | 18 | 8 | 26 |
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| 2017 Marzo | 8 | 3 | 11 |
| 2017 Febrero | 2 | 0 | 2 |
| 2017 Enero | 6 | 5 | 11 |
| 2016 Diciembre | 27 | 20 | 47 |
| 2016 Noviembre | 18 | 7 | 25 |
| 2016 Octubre | 28 | 14 | 42 |
| 2016 Septiembre | 30 | 6 | 36 |
| 2016 Agosto | 37 | 19 | 56 |
| 2016 Julio | 22 | 13 | 35 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Octubre | 0 | 10 | 10 |
| 2015 Agosto | 1 | 11 | 12 |
| 2015 Julio | 2 | 6 | 8 |
| 2015 Junio | 12 | 7 | 19 |
| 2015 Mayo | 22 | 10 | 32 |
| 2015 Abril | 20 | 15 | 35 |
| 2015 Marzo | 13 | 8 | 21 |
| 2015 Febrero | 12 | 13 | 25 |
| 2015 Enero | 15 | 13 | 28 |
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| 2014 Noviembre | 13 | 10 | 23 |
| 2014 Octubre | 19 | 17 | 36 |
| 2014 Septiembre | 15 | 15 | 30 |
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| 2014 Febrero | 11 | 15 | 26 |
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| 2013 Octubre | 15 | 17 | 32 |
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