Document Detail


Long-term outcome of gamma knife radiosurgery for treatment of typical trigeminal neuralgia.
MedLine Citation:
PMID:  19515510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the long-term outcomes of patients with typical trigeminal neuralgia treated with gamma knife radiosurgery (GKRS). PATIENTS AND METHODS: A total of 62 consecutive patients with typical trigeminal neuralgia were treated with GKRS between 1998 and 2004. Of the 62 patients, 2 were lost to follow-up; the remaining 60 patients were followed for >12 months. The mean prescribed maximal dose was 79.7 Gy (range, 75-80), using a 4-mm shot. RESULTS: Of the 60 patients, 48 were followed for >4 years. An additional 3 patients, followed for <4 years, experienced recurrent pain after a favorable initial response and were incorporated into the long-term response analysis. Of these 51 patients (mean age, 61 +/- 11 years; 37 women [72.5%]; and mean follow-up duration, 58 +/- 14 months), 46 (90.2%) responded to GKRS, as demonstrated by an improvement in their Barrow Neurological Institute pain intensity score. Of the 46 patients, 24 (52.2%) had pain recurrence. The actuarial recurrence-free survival rate was 84.8%, 76.1%, 69.6%, 63.0%, and 45.8% at 1, 2, 3, 4, and 5 years after radiosurgery, respectively. Patient age >70 years correlated with a favorable outcome in terms of pain recurrence after radiosurgery (hazard ratio, 0.125; 95% confidence interval, 0.016-0.975; p = .047) on multivariate analysis. CONCLUSION: GKRS seems to be an effective treatment modality for patients with typical trigeminal neuralgia considering the initial response rate; however, fewer than one-half of patients might continue to benefit from GKRS after long-term follow-up. Elderly patients might be good candidates for radiosurgery considering the long-term durability of efficacy.
Authors:
Jung Ho Han; Dong Gyu Kim; Hyun-Tai Chung; Sun Ha Paek; Yong Hwy Kim; Chae-Yong Kim; Jin Wook Kim; Young-Hoon Kim; Sang Soon Jeong
Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-06-08
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  75     ISSN:  1879-355X     ISO Abbreviation:  Int. J. Radiat. Oncol. Biol. Phys.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-05     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  United States    
Other Details:
Languages:  eng     Pagination:  822-7     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Seoul National University College of Medicine, 28 Yeongeon-dong, Chongno-gu, Seoul, Korea. gknife@plaza.snu.ac.kr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Analysis of Variance
Disease-Free Survival
Female
Follow-Up Studies
Humans
Male
Middle Aged
Pain Measurement
Radiosurgery*
Radiotherapy Dosage
Recurrence
Treatment Outcome
Trigeminal Neuralgia / surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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