Allan Y Chen1,2, Yen Hsieh2, Steffanie McNair1, Qijuan Li1, Kevin Y Xu1, Conrad Pappas3. 1. Department of Radiation Oncology, Roseville Medical Center, The Permanente Medical Group, Roseville, CA 95678, USA. 2. Department of Medicine, UC Davis Medical School, Davis, CA 95817, USA. 3. Department of Neurosurgery, Sacramento Medical Center, The Permanente Medical Group, Sacramento, CA 95825, USA.
Abstract
PURPOSE: We report outcome of linear accelerator (Linac)-based stereotactic radiosurgery (SRS) for trigeminal neuralgia (TGN) utilizing rigid head frame (RF) and facemask (FM) immobilization.Method: From November 2008 to October 2012, 48 patients with idiopathic TGN underwent primary SRS by a dedicated Linac. RF immobilization was utilized for 34 patients, and frameless image-guided radiosurgery (IGRS) with FM immobilization was performed in 14 patients. Treatment outcome was assessed by patient interviews with a 7-item questionnaire. RESULTS: Sub-millimeter targeting accuracy (0.71±0.31 mm) was recorded for frameless IGRS by a novel hidden-target phantom method. With a follow-up of 26 months, significant pain relief was recorded in 43 (89%) patients, including 26 (54%) complete and 17 (35%) partial responses; with a significant reduction of 2.4±1.3 points (p < 0.01) on the 5-point Barrow Neurological Institute pain scale. No significant pain relief difference (p = 0.23) was detected between patients immobilized by RF and FM. Notable pin site problems were reported in 9 (26%) of 34 patients immobilized by RF. CONCLUSION: Frameless IGRS with FM immobilization is more patient friendly and can achieve as excellent treatment outcome as with RF immobilization for idiopathic TGN.
PURPOSE: We report outcome of linear accelerator (Linac)-based stereotactic radiosurgery (SRS) for trigeminal neuralgia (TGN) utilizing rigid head frame (RF) and facemask (FM) immobilization.Method: From November 2008 to October 2012, 48 patients with idiopathic TGN underwent primary SRS by a dedicated Linac. RF immobilization was utilized for 34 patients, and frameless image-guided radiosurgery (IGRS) with FM immobilization was performed in 14 patients. Treatment outcome was assessed by patient interviews with a 7-item questionnaire. RESULTS: Sub-millimeter targeting accuracy (0.71±0.31 mm) was recorded for frameless IGRS by a novel hidden-target phantom method. With a follow-up of 26 months, significant pain relief was recorded in 43 (89%) patients, including 26 (54%) complete and 17 (35%) partial responses; with a significant reduction of 2.4±1.3 points (p < 0.01) on the 5-point Barrow Neurological Institute pain scale. No significant pain relief difference (p = 0.23) was detected between patients immobilized by RF and FM. Notable pin site problems were reported in 9 (26%) of 34 patients immobilized by RF. CONCLUSION: Frameless IGRS with FM immobilization is more patient friendly and can achieve as excellent treatment outcome as with RF immobilization for idiopathic TGN.
Authors: John C Breneman; Ryan Steinmetz; Aaron Smith; Michael Lamba; Ronald E Warnick Journal: Int J Radiat Oncol Biol Phys Date: 2009-02-21 Impact factor: 7.038
Authors: Tobias Greve; Felix Ehret; Theresa Hofmann; Jun Thorsteinsdottir; Franziska Dorn; Viktor Švigelj; Anita Resman-Gašperšič; Joerg-Christian Tonn; Christian Schichor; Alexander Muacevic Journal: Front Oncol Date: 2021-03-09 Impact factor: 6.244