title: CyberKnife radiosurgery for trigeminal neuralgia: unanticipated iatrogenic effect following successful treatment.
abstract: This case report of 74-year-old man with trigeminal neuralgia is presented to underscore the importance of evaluating the entire treatment plan, especially when delivering large doses where even a low percentage of the prescription dose can contribute a substantial dose to an unintended target. The patient was treated using the CyberKnife stereotactic radiosurgery system utilizing a nonisocentric beam treatment plan with a 5-mm fixed collimator generating 111 beams to deliver 6000 cGy to the 79% isodose line with a maximum dose of 7594 cGy to the target. Two weeks after treatment the patient's trigeminal neuralgia symptoms resolved; however, the patient developed oral mucositis due to the treatment. This case report reviews the cause of mucositis and makes recommendations on how to prevent unintended targets from receiving treatment.
authors.affiliation: Department of Radiation Oncology, Penrose Cancer Center, Colorado Springs, Colorado 80906, USA. anujpeddada@yahoo.com
authors.forename: Anuj V
authors.initials: AV
authors.lastname: Peddada
authors.forename: D James
authors.initials: DJ
authors.lastname: Sceats
authors.forename: Gerald A
authors.initials: GA
authors.lastname: White
authors.forename: Gyongyver
authors.initials: G
authors.lastname: Bulz
authors.forename: Greg L
authors.initials: GL
authors.lastname: Gibbs
authors.forename: Barry
authors.initials: B
authors.lastname: Switzer
authors.forename: Susan
authors.initials: S
authors.lastname: Anderson
authors.forename: Alan T
authors.initials: AT
authors.lastname: Monroe
mesh_terms: D000368:Aged; D006801:Humans; D008297:Male; D016634:Radiosurgery / Q000009:adverse effects*; D013280:Stomatitis / Q000209:etiology*; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000601:surgery*