title: Stereotactic radiosurgery for trigeminal pain secondary to benign skull base tumors.
abstract: OBJECTIVE
  To assess the outcome of stereotactic radiosurgery (SRS) for patients with benign skull base tumors and trigeminal-related facial pain.
  
  
  METHODS
  We undertook a retrospective review of 31 consecutive patients (25 women, 6 men) with benign skull base tumors and trigeminal pain who underwent SRS between 1991 and 2008. The tumors included 17 posterior fossa meningiomas, 9 cavernous sinus meningiomas, and 5 trigeminal schwannomas. The median patient age was 62 years (range, 17-81 years). In all cases the tumor was the primary target for SRS. The median follow-up after SRS was 50 months (range, 12-184 months).
  
  
  RESULTS
  The actuarial tumor control rate after SRS was 95% at both 3 years and 5 years. Eighteen patients (58%) initially achieved complete resolution of trigeminal pain. Higher maximum dose was associated with initial complete pain resolution on a multivariate analysis. However, 7 patients had recurrent pain during follow-up. At last follow-up, only 7 patients (23%) remained pain-free off medications. Further treatment in addition to medical therapy was required for 6 patients (19%).
  
  
  CONCLUSIONS
  Although SRS offers excellent radiographic tumor control for benign skull base tumors, durable relief of tumor-related trigeminal pain without medication was noted in only one-fourth of patients at last follow-up.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA.
authors.forename: Shota
authors.initials: S
authors.lastname: Tanaka
authors.forename: Bruce E
authors.initials: BE
authors.lastname: Pollock
authors.forename: Scott L
authors.initials: SL
authors.lastname: Stafford
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Link
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005157:Facial Pain / Q000209:etiology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000601:surgery*; D055815:Young Adult