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Outcomes using linear accelerator stereotactic radiosurgery for the treatment of trigeminal neuralgia: A single-center, retrospective study

BACKGROUND: Linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) treatment of trigeminal neuralgia (TN) may have similar efficacy to Gamma Knife SRS (GK-SRS), but the preponderance of data comes from patients treated with GK-SRS. Our objective was to analyze the outcomes for LINAC-based...

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Detalles Bibliográficos
Autores principales: Kundu, Bornali, Brock, Andrea A., Garry, Jason G., Jensen, Randy L., Burt, Lindsay M., Cannon, Donald M., Shrieve, Dennis C., Rolston, John D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9282731/
https://www.ncbi.nlm.nih.gov/pubmed/35855130
http://dx.doi.org/10.25259/SNI_91_2022
Descripción
Sumario:BACKGROUND: Linear accelerator (LINAC)-based stereotactic radiosurgery (SRS) treatment of trigeminal neuralgia (TN) may have similar efficacy to Gamma Knife SRS (GK-SRS), but the preponderance of data comes from patients treated with GK-SRS. Our objective was to analyze the outcomes for LINAC-based treatment of TN in patients at our institution. METHODS: We retrospectively analyzed data for patients who underwent LINAC-based SRS for TN from 2006 to 2018. Data were collected from the patients’ medical records. Nonparametric statistics were used for the analysis. RESULTS: Of the 41 patients treated with LINAC-based SRS (typically 90 Gy dosed using a 4 mm collimator for one fraction) during that time, follow-up data of >3 weeks post-SRS were available for 32 patients. The median pretreatment Barrow Neurological Institute (BNI) pain score was 5 (range 4–5). The follow-up period ranged from 0.9 to 113.2 months (median 5 months). There was significant improvement in postradiation BNI pain score (P < 0.001), with 23 (72%) patients who improved to a BNI pain score of 1–3. One patient had bothersome hypoesthesia postradiation. Approximately 38% of patients who had initial pain control had recurrence of symptoms (BNI > 3). Survival analysis showed a median time to pain recurrence of 30 months. There was no relationship between prior microvascular decompression (MVD) surgery and change in BNI pain score pre- to posttreatment. CONCLUSION: The results demonstrate that LINAC-based SRS is an effective means to treat TN. Prior MVD surgery did not affect efficacy of SRS in lowering the BNI score from pre- to posttreatment in this patient cohort.