OBJECTIVE: To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. METHODS: Twenty-eight patients with medication refractory idiopathic trigeminal neuralgia were treated with a single fraction of 80 Gy to the trigeminal nerve root. For treatment delivery, a 4-mm collimator and a 7-arc technique were delivered using a stereotactic floor stand system with an isocenter stability of 0.2 +/- 0.1 mm to minimize dose to the brainstem. Treatment delivery time was approximately 55 minutes. RESULTS: With a median follow-up of 12 months (range, 1-40 mo), 57% of patients achieved complete pain relief and 75% (exact 95% confidence interval, 55 to 89%) had their pain reduced to 3 or less on a 10-point pain scale. Median time to pain relief was 1 month. Four patients did not respond to treatment. The actuarial mean time to pain recurrence in responders was 14 months, and the actuarial mean response duration in major to complete responders was 16 months. Women had significantly longer mean time to pain recurrence than men (16 versus 7 months; P = 0.05). Three patients reported new mild facial numbness after radiosurgery and one patient developed neurotrophic keratopathy. CONCLUSION: Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.
OBJECTIVE: To report the clinical outcomes following treatment of trigeminal neuralgia with linear accelerator-based radiosurgery. METHODS: Twenty-eight patients with medication refractory idiopathic trigeminal neuralgia were treated with a single fraction of 80 Gy to the trigeminal nerve root. For treatment delivery, a 4-mm collimator and a 7-arc technique were delivered using a stereotactic floor stand system with an isocenter stability of 0.2 +/- 0.1 mm to minimize dose to the brainstem. Treatment delivery time was approximately 55 minutes. RESULTS: With a median follow-up of 12 months (range, 1-40 mo), 57% of patients achieved complete pain relief and 75% (exact 95% confidence interval, 55 to 89%) had their pain reduced to 3 or less on a 10-point pain scale. Median time to pain relief was 1 month. Four patients did not respond to treatment. The actuarial mean time to pain recurrence in responders was 14 months, and the actuarial mean response duration in major to complete responders was 16 months. Women had significantly longer mean time to pain recurrence than men (16 versus 7 months; P = 0.05). Three patients reported new mild facial numbness after radiosurgery and one patient developed neurotrophic keratopathy. CONCLUSION: Linear accelerator-based radiosurgery for medication refractory trigeminal neuralgia provides effective pain relief with a low complication rate.
Authors: Karina P Esparza-Moreno; Olivia A García-Garduño; Paola Ballesteros-Zebadúa; José M Lárraga-Gutiérrez; Sergio Moreno-Jiménez; Miguel A Celis-Lopez Journal: J Appl Clin Med Phys Date: 2013-11-04 Impact factor: 2.102
Authors: Lisa B E Shields; Todd S Shanks; Andrew J Shearer; Lauren A Shelton; Brent J Shelton; Jonathan Howe; James M Coons; Brian Plato; Aaron C Spalding Journal: Surg Neurol Int Date: 2017-05-26
Authors: Richard A Popple; Xingen Wu; Ivan A Brezovich; James M Markert; Barton L Guthrie; Evan M Thomas; Markus Bredel; John B Fiveash Journal: Adv Radiat Oncol Date: 2018-03-02
Authors: Ali Rashid; Bogdan Pintea; Thomas M Kinfe; Gunnar Surber; Klaus Hamm; Jan P Boström Journal: Radiat Oncol Date: 2018-08-22 Impact factor: 3.481