title: Gamma knife radiosurgery in the treatment of tumor-related facial pain.
abstract: BACKGROUND
  Intracranial neoplasms can cause pain similar to trigeminal neuralgia. Literature regarding radiosurgery for this is limited. We present a retrospective review of patients with tumor-related facial pain from benign lesions treated with gamma knife radiosurgery (GKRS) at Wake Forest University.
  
  
  OBJECTIVE
  The primary objectives were to determine long-term pain relief and predictive factors for pain alleviation.
  
  
  METHODS
  We reviewed 515 patients treated with GKRS for benign meningioma, vestibular schwannoma or trigeminal schwannoma between August 1999 and August 2010. Twenty-one eligible patients had tumor-related facial pain prior to GKRS. The median marginal tumor dose was 12 Gy. Long-term pain relief data were obtained by chart review and telephone interview.
  
  
  RESULTS
  The median follow-up for symptom evaluation was 3.8 years. Seventeen of 21 patients (81%) experienced a Barrow Neurological Institute (BNI) score of I-III at 6 months following GKRS. Kaplan-Meier estimates of freedom from BNI IV-V relapse were 66% at 1 year and 53% at 2 years. No pain relapses occurred after 2 years.
  
  
  CONCLUSIONS
  GKRS of benign lesions is a noninvasive option for patients with tumor-related facial pain. Pain relief is modest, with the majority of pain relapses occurring within 2 years and approximately one half of patients maintaining relief beyond 2 years.
authors.affiliation: Department of Radiation Oncology, Wake Forest University, Winston-Salem, NC, USA. sarahsquire@gmail.com
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Squire
authors.forename: Michael D
authors.initials: MD
authors.lastname: Chan
authors.forename: R Michael
authors.initials: RM
authors.lastname: Furr
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Lowell
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Tatter
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Ellis
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Bourland
authors.forename: Allan F
authors.initials: AF
authors.lastname: Deguzman
authors.forename: Michael T
authors.initials: MT
authors.lastname: Munley
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Ekstrand
authors.forename: Edward G
authors.initials: EG
authors.lastname: Shaw
authors.forename: Kevin P
authors.initials: KP
authors.lastname: McMullen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D005157:Facial Pain / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008579:Meningioma / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000601:surgery*; D010147:Pain Measurement; D016634:Radiosurgery / Q000295:instrumentation*; D012189:Retrospective Studies; D016896:Treatment Outcome