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Title: Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia

Abstract

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;more » 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.« less

Authors:
 [1];  [1]; ; ; ; ; ; ;  [1]
  1. Department of Neurosurgery, Seoul National University College of Medicine, Seoul (Korea, Republic of)
Publication Date:
OSTI Identifier:
21362221
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 75; Journal Issue: 3; Other Information: DOI: 10.1016/j.ijrobp.2008.11.046; PII: S0360-3016(08)03844-3; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; FACE; PAIN; RADIOTHERAPY; SURGERY; BODY; HEAD; MEDICINE; NUCLEAR MEDICINE; RADIOLOGY; SYMPTOMS; THERAPY

Citation Formats

Han, Jung Ho, Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.k, Chung, Hyun-Tai, Paek, Sun Ha, Kim, Yong Hwy, Kim, Chae-Yong, Kim, Jin Wook, Kim, Young-Hoon, and Jeong, Sang Soon. Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.11.046.
Han, Jung Ho, Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.k, Chung, Hyun-Tai, Paek, Sun Ha, Kim, Yong Hwy, Kim, Chae-Yong, Kim, Jin Wook, Kim, Young-Hoon, & Jeong, Sang Soon. Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia. United States. doi:10.1016/j.ijrobp.2008.11.046.
Han, Jung Ho, Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.k, Chung, Hyun-Tai, Paek, Sun Ha, Kim, Yong Hwy, Kim, Chae-Yong, Kim, Jin Wook, Kim, Young-Hoon, and Jeong, Sang Soon. Sun . "Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia". United States. doi:10.1016/j.ijrobp.2008.11.046.
@article{osti_21362221,
title = {Long-Term Outcome of Gamma Knife Radiosurgery for Treatment of Typical Trigeminal Neuralgia},
author = {Han, Jung Ho and Kim, Dong Gyu, E-mail: gknife@plaza.snu.ac.k and Chung, Hyun-Tai and Paek, Sun Ha and Kim, Yong Hwy and Kim, Chae-Yong and Kim, Jin Wook and Kim, Young-Hoon and Jeong, Sang Soon},
abstractNote = {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.},
doi = {10.1016/j.ijrobp.2008.11.046},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 3,
volume = 75,
place = {United States},
year = {2009},
month = {11}
}