Tags

Type your tag names separated by a space and hit enter

Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience.
Neurosurgery. 2008 Mar; 62(3):647-55; discussion 647-55.N

Abstract

OBJECTIVE

Radiosurgery has gained acceptance as a treatment option for trigeminal neuralgia. We report our preliminary multicenter experience treating trigeminal neuralgia with the CyberKnife (Accuray, Inc., Sunnyvale, CA).

METHODS

A total of 95 patients were treated for idiopathic trigeminal neuralgia between May 2002 and October 2005. Radiosurgical dose and volume parameters were retrospectively analyzed in relation to pain response, complications, and recurrence of symptoms. Optimal treatment parameters were identified for patients who had excellent and sustained pain relief with no complications, including severe or moderate hypesthesia.

RESULTS

Excellent pain relief was initially experienced by 64 out of 95 patients (67%). The median time to pain relief was 14 days (range, 0.3-180 d). Posttreatment numbness occurred in 45 (47%) of the patients treated. Using higher radiation doses and treating longer segments of the nerve led to both better pain relief and a higher incidence of hypesthesia. The presence of posttreatment numbness was predictive of better pain relief. The overall rate of complications was 18%. At the mean follow-up time of 2 years, 47 of the 95 patients (50%) had sustained pain relief, all of whom were completely off pain medications.

CONCLUSION

The results of this study suggest the following optimal radiosurgical treatment parameters for treatment of idiopathic trigeminal neuralgia: a median maximal dose of 78 Gy (range, 70-85.4 Gy) and a median length of the nerve treated of 6 mm (range, 5-12 mm).

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Villavicencio AT
Boulder Neurosurgical Associates, Boulder, Colorado 80304, USA. atv@bnasurg.com
Lim M
No affiliation info available
Burneikiene S
No affiliation info available
Romanelli P
No affiliation info available
Adler JR
No affiliation info available
McNeely L
No affiliation info available
Chang SD
No affiliation info available
Fariselli L
No affiliation info available
McIntyre M
No affiliation info available
Bower R
No affiliation info available
Broggi G
No affiliation info available
Thramann JJ
No affiliation info available

MeSH

AdultAgedAged, 80 and overCaliforniaFemaleHumansMaleMiddle AgedPainPain MeasurementPilot ProjectsRadiosurgeryTreatment OutcomeTrigeminal Neuralgia

Pub Type(s)

Classical Article
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18425011

Citation

Villavicencio, Alan T., et al. "Cyberknife Radiosurgery for Trigeminal Neuralgia Treatment: a Preliminary Multicenter Experience." Neurosurgery, vol. 62, no. 3, 2008, pp. 647-55; discussion 647-55.
Villavicencio AT, Lim M, Burneikiene S, et al. Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience. Neurosurgery. 2008;62(3):647-55; discussion 647-55.
Villavicencio, A. T., Lim, M., Burneikiene, S., Romanelli, P., Adler, J. R., McNeely, L., Chang, S. D., Fariselli, L., McIntyre, M., Bower, R., Broggi, G., & Thramann, J. J. (2008). Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience. Neurosurgery, 62(3), 647-55; discussion 647-55. https://doi.org/10.1227/01.neu.0000317313.46826.dc
Villavicencio AT, et al. Cyberknife Radiosurgery for Trigeminal Neuralgia Treatment: a Preliminary Multicenter Experience. Neurosurgery. 2008;62(3):647-55; discussion 647-55. PubMed PMID: 18425011.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cyberknife radiosurgery for trigeminal neuralgia treatment: a preliminary multicenter experience. AU - Villavicencio,Alan T, AU - Lim,Michael, AU - Burneikiene,Sigita, AU - Romanelli,Pantaleo, AU - Adler,John R, AU - McNeely,Lee, AU - Chang,Steven D, AU - Fariselli,Laura, AU - McIntyre,Melinda, AU - Bower,Regina, AU - Broggi,Giovanni, AU - Thramann,Jeffrey J, PY - 2008/4/22/pubmed PY - 2008/6/21/medline PY - 2008/4/22/entrez SP - 647-55; discussion 647-55 JF - Neurosurgery JO - Neurosurgery VL - 62 IS - 3 N2 - OBJECTIVE: Radiosurgery has gained acceptance as a treatment option for trigeminal neuralgia. We report our preliminary multicenter experience treating trigeminal neuralgia with the CyberKnife (Accuray, Inc., Sunnyvale, CA). METHODS: A total of 95 patients were treated for idiopathic trigeminal neuralgia between May 2002 and October 2005. Radiosurgical dose and volume parameters were retrospectively analyzed in relation to pain response, complications, and recurrence of symptoms. Optimal treatment parameters were identified for patients who had excellent and sustained pain relief with no complications, including severe or moderate hypesthesia. RESULTS: Excellent pain relief was initially experienced by 64 out of 95 patients (67%). The median time to pain relief was 14 days (range, 0.3-180 d). Posttreatment numbness occurred in 45 (47%) of the patients treated. Using higher radiation doses and treating longer segments of the nerve led to both better pain relief and a higher incidence of hypesthesia. The presence of posttreatment numbness was predictive of better pain relief. The overall rate of complications was 18%. At the mean follow-up time of 2 years, 47 of the 95 patients (50%) had sustained pain relief, all of whom were completely off pain medications. CONCLUSION: The results of this study suggest the following optimal radiosurgical treatment parameters for treatment of idiopathic trigeminal neuralgia: a median maximal dose of 78 Gy (range, 70-85.4 Gy) and a median length of the nerve treated of 6 mm (range, 5-12 mm). SN - 1524-4040 UR - https://www.unboundmedicine.com/medline/citation/18425011/Cyberknife_radiosurgery_for_trigeminal_neuralgia_treatment:_a_preliminary_multicenter_experience_ DB - PRIME DP - Unbound Medicine ER -