{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:49:55Z","timestamp":1772110195803,"version":"3.50.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100012173","name":"Elite Medical Professionals Project of China-Japan Friendship Hospital","doi-asserted-by":"publisher","award":["NO.ZRJY2023-QM25"],"award-info":[{"award-number":["NO.ZRJY2023-QM25"]}],"id":[{"id":"10.13039\/501100012173","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National High Level Hospital Clinical Research Funding"},{"DOI":"10.13039\/100014717","name":"Youth Fund of the National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82301470"],"award-info":[{"award-number":["82301470"]}],"id":[{"id":"10.13039\/100014717","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The role of radiosurgery in preventing haemorrhage in brainstem cavernous malformations remains a subject of debate. This study aimed to evaluate whether radiosurgery provides a protective benefit against haemorrhage in these patients. This multicentre, prospective observational study was conducted in 17 centres and enrolled eligible patients with brainstem cavernous malformations consecutively. Data collected included clinical baseline information, radiosurgery planning details, periodic follow-up evaluations and any adverse radiation effects. The primary outcome of the study was the incidence of first prospective haemorrhage, and the secondary outcome was the development of new or worsening neurological dysfunctions. The impact of radiosurgery was assessed using multivariate Cox regression analysis. From March 2016 to August 2018, the study enrolled 377 patients: 280 in the observation group receiving standard care alone and 97 in the radiosurgery group receiving both radiosurgery and standard care. The overall cohort consisted of 173 females (45.9%) with a mean age of 40.5 years (range, 18\u201368 years), and there were no significant differences in baseline characteristics between the two groups. After a median follow-up period of 70 months, haemorrhage occurred in 25.0% (n = 70) of patients in the observation group and 10.3% (n = 10) of patients in the radiosurgery group. Multivariate Cox regression analysis identified radiosurgery as an independent protective factor against haemorrhage (hazard ratio 0.379, 95% confidence interval 0.195\u20130.738, P = 0.004). Following 1:2 propensity score matching, the incidence of prospective haemorrhage was 24.9% (45\/181) in the observation group compared with 10.3% (10\/97) in the radiosurgery group (hazard ratio 0.379, 95% confidence interval 0.190\u20130.755, P = 0.006). Adverse radiation effects were observed in 12 patients (12.4%), with none being permanent. Additionally, new or worsening neurological dysfunctions were significantly more common in the observation group (28.9%) compared with the radiosurgery group (16.5%) (P = 0.016). These results suggest that radiosurgery is associated with a low rate of haemorrhage in patients with brainstem cavernous malformations and could provide a benefit in selected patients. However, further research is required to confirm these findings.<\/jats:p>","DOI":"10.1093\/brain\/awae337","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T09:34:02Z","timestamp":1729762442000},"page":"1134-1143","source":"Crossref","is-referenced-by-count":6,"title":["Radiosurgery versus observation for brainstem cavernous malformations: a 5-year multicentre cohort study"],"prefix":"10.1093","volume":"148","author":[{"given":"Da","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University , Beijing 100070 ,","place":["China"]},{"name":"China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing 100071 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-Cong","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, China-Japan Friendship Hospital , Beijing 100029 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-Bin","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Gamma Knife Centre, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University , Beijing 100070 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gui-Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Centre, Shandong Provincial Hospital Affiliated to Shandong First Medical University , Jinan 250021 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo-Han","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University , Beijing 100070 ,","place":["China"]},{"name":"China National Clinical Research Centre for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University , Beijing 100071 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guo-Kai","family":"Wang","sequence":"additional","affiliation":[{"name":"Neuro-oncology Centre and Gamma Knife Centre, Tianjin Huanhu Hospital , Tianjin 300060 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Gamma Knife Centre, Sichuan University West China Hospital , Chengdu 610041 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shou-Xin","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Stereotactic Radiosurgery, Affiliated Hospital of Xuzhou Medical University , Xuzhou 221002 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hai-Tao","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, The Second People\u2019s Hospital of Lianyungang , Lianyungang 222006 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fu-Gui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, The Second People\u2019s Hospital of Lianyungang , Lianyungang 222006 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan-Pan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second Affiliated Hospital of Chengdu Medical College, China National Nuclear Corporation 416 Hospital , Chengdu 610051 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Kong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Qingdao Municipal Hospital, Qingdao University , Qingdao 266011 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First People\u2019s Hospital of Lianyungang , Lianyungang 222002 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao-Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University , Beijing 100020 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-Jun","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Second People\u2019s Hospital of Shenzhen , Shenzhen 518035 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ze-Yu","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, the Affiliated Hospital of Qingdao University , Qingdao, Shandong Province 266071 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiu-Luan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Tsinghua university, Yuquan Hospital , Beijing 100049 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cong","family":"Ren","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Electric Power Hospital , Beijing 100073 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Peking University Binhai Hospital , Tianjin 300270 ,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Puhua Hospital , Beijing 100010 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A meta-analysis of individual patient data","volume":"15","author":"Horne","year":"2016","journal-title":"Lancet Neurol"},{"key":"2025040317000346100_awae337-B4","doi-asserted-by":"crossref","first-page":"1984","DOI":"10.1212\/WNL.0000000000002701","article-title":"Natural history of cavernous malformation: Systematic review and meta-analysis of 25 studies","volume":"86","author":"Taslimi","year":"2016","journal-title":"Neurology"},{"key":"2025040317000346100_awae337-B5","doi-asserted-by":"crossref","first-page":"2961","DOI":"10.1007\/s10143-022-01815-2","article-title":"Five-year symptomatic hemorrhage risk of untreated brainstem cavernous malformations in a prospective cohort","volume":"45","author":"Kong","year":"2022","journal-title":"Neurosurg Rev"},{"key":"2025040317000346100_awae337-B6","doi-asserted-by":"crossref","first-page":"e1971","DOI":"10.1212\/WNL.0000000000008521","article-title":"Stereotactic radiosurgery for cerebral cavernous malformations: A systematic 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