For large AVMs that cannot meet the V12 dose constraint, how low are you willing to go in terms of single fraction dosing?
When do you decide to fractionate?
Answer from: Radiation Oncologist at Academic Institution
We usually use a “volume staging” approach by treating part of the AVM to 18-20 Gy in one fraction (meeting the V12 dose constraint), and return to treat the remaining nidus about 2 years later. Generally most or all of the treated nidus has occluded by then. There will of course b...
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