Long-term follow-up of trigeminal neuralgia treatment using a linear accelerator.
While most of the studies examining radiosurgery for trigeminal neuralgia have used a Gamma Knife, a linear accelerator can also be utilized for treatment. We report on 20 patients with trigeminal neuralgia who received 23 treatments with a linear accelerator that delivered a maximum dose of 82.3-100 Gy. The median patient follow-up was 56.5 months, 70% of patients had received previous surgical treatment and 20% had secondary (nonessential) trigeminal neuralgia. Eight (35%) radiosurgery treatments resulted in complete pain relief; 5 (63%) patients with initial pain relief had pain recurrence at a mean time of 21.5 months. Ten (43%) patients reported a 50% or more decrease in pain severity but have not achieved a pain-free state. A total of 18 (78%) treatments resulted in no pain or a 50% or greater improvement in pain. Five treatments (22%) resulted in less than 50% improvement in pain. We conclude that linear accelerator stereotactic radiosurgery is a viable treatment option for trigeminal neuralgia patients, especially for patients who have not had a previous invasive treatment.
Kubicek
Gregory J
GJ
Department of Therapeutic Radiology-Radiation Oncology, University of Minnesota, Minneapolis, Minn., USA. kubi0052@umn.edu
Hall
Walter A
WA
Orner
Jamie B
JB
Gerbi
Bruce J
BJ
Dusenbery
Kathryn E
KE
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods / Q000706:statistics & numerical data; D013997:Time Factors; D014277:Trigeminal Neuralgia / Q000503:physiopathology / Q000601:surgery*