PURPOSE: To analyze the long-term outcomes of patients with typical trigeminal neuralgia treated with gamma knife radiosurgery (GKRS). PATIENTS AND METHODS: A total of 62 consecutive patients with typical trigeminal neuralgia were treated with GKRS between 1998 and 2004. Of the 62 patients, 2 were lost to follow-up; the remaining 60 patients were followed for >12 months. The mean prescribed maximal dose was 79.7 Gy (range, 75-80), using a 4-mm shot. RESULTS: Of the 60 patients, 48 were followed for >4 years. An additional 3 patients, followed for <4 years, experienced recurrent pain after a favorable initial response and were incorporated into the long-term response analysis. Of these 51 patients (mean age, 61 +/- 11 years; 37 women [72.5%]; and mean follow-up duration, 58 +/- 14 months), 46 (90.2%) responded to GKRS, as demonstrated by an improvement in their Barrow Neurological Institute pain intensity score. Of the 46 patients, 24 (52.2%) had pain recurrence. The actuarial recurrence-free survival rate was 84.8%, 76.1%, 69.6%, 63.0%, and 45.8% at 1, 2, 3, 4, and 5 years after radiosurgery, respectively. Patient age >70 years correlated with a favorable outcome in terms of pain recurrence after radiosurgery (hazard ratio, 0.125; 95% confidence interval, 0.016-0.975; p = .047) on multivariate analysis. CONCLUSION: GKRS seems to be an effective treatment modality for patients with typical trigeminal neuralgia considering the initial response rate; however, fewer than one-half of patients might continue to benefit from GKRS after long-term follow-up. Elderly patients might be good candidates for radiosurgery considering the long-term durability of efficacy.
PURPOSE: To analyze the long-term outcomes of patients with typical trigeminal neuralgia treated with gamma knife radiosurgery (GKRS). PATIENTS AND METHODS: A total of 62 consecutive patients with typical trigeminal neuralgia were treated with GKRS between 1998 and 2004. Of the 62 patients, 2 were lost to follow-up; the remaining 60 patients were followed for >12 months. The mean prescribed maximal dose was 79.7 Gy (range, 75-80), using a 4-mm shot. RESULTS: Of the 60 patients, 48 were followed for >4 years. An additional 3 patients, followed for <4 years, experienced recurrent pain after a favorable initial response and were incorporated into the long-term response analysis. Of these 51 patients (mean age, 61 +/- 11 years; 37 women [72.5%]; and mean follow-up duration, 58 +/- 14 months), 46 (90.2%) responded to GKRS, as demonstrated by an improvement in their Barrow Neurological Institute pain intensity score. Of the 46 patients, 24 (52.2%) had pain recurrence. The actuarial recurrence-free survival rate was 84.8%, 76.1%, 69.6%, 63.0%, and 45.8% at 1, 2, 3, 4, and 5 years after radiosurgery, respectively. Patient age >70 years correlated with a favorable outcome in terms of pain recurrence after radiosurgery (hazard ratio, 0.125; 95% confidence interval, 0.016-0.975; p = .047) on multivariate analysis. CONCLUSION: GKRS seems to be an effective treatment modality for patients with typical trigeminal neuralgia considering the initial response rate; however, fewer than one-half of patients might continue to benefit from GKRS after long-term follow-up. Elderly patients might be good candidates for radiosurgery considering the long-term durability of efficacy.
Authors: Ameer L Elaimy; Peter W Hanson; Wayne T Lamoreaux; Alexander R Mackay; John J Demakas; Robert K Fairbanks; Barton S Cooke; Sudheer R Thumma; Christopher M Lee Journal: Int J Otolaryngol Date: 2011-10-25
Authors: Sana D Karam; Alexander Tai; Margaux Wooster; Abdul Rashid; Rosanna Chen; Nimrah Baig; Ann Jay; K William Harter; Pamela Randolph-Jackson; Adedamola Omogbehin; Edward F Aulisi; Jeff Jacobson Journal: J Radiat Oncol Date: 2013-11-20
Authors: Mena G Kerolus; Neilayan Sen; Sonal Mayekar; Alistar Templeton; Julius Turian; Aidnag Diaz; Lorenzo Munoz; Richard W Byrne; Sepehr Sani Journal: Cureus Date: 2017-06-16