Preliminary results of 45 patients with trigeminal neuralgia treated with radiosurgery compared to hypofractionated stereotactic radiotherapy, using a dedicated linear accelerator

被引:17
作者
Fraioli, Mario Francesco [1 ]
Strigari, Lidia [2 ,3 ]
Fraioli, Chiara [3 ]
Lecce, Mario [1 ]
Lisciani, Damiano [1 ]
机构
[1] Univ Roma Tor Vergata, Dept Neurosci, I-00133 Rome, Italy
[2] Regina Elena Inst Canc Res, Dept Med Phys & Expert Syst, Rome, Italy
[3] C I RAD Villa Benedetta, Dept Radiotherapy, Rome, Italy
关键词
Hypofractionated stereotactic radiotherapy; Radiosurgery; Retrogasserian target; Trigeminal neuralgia; GAMMA-KNIFE SURGERY; THERMOCOAGULATION; GANGLION;
D O I
10.1016/j.jocn.2011.11.036
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Radiosurgery (RS) and hypofractionated stereotactic radiotherapy (HSRT) were performed in 23 and 22 patients respectively for the treatment of trigeminal neuralgia. RS and HSRT were performed with a dedicated linear accelerator (LINAC): an invasive frame (for RS) or a relocatable stereotactic frame fitted with a thermoplastic mask and bite blocks (HSRT) were used for positioning patients. The RS treatment delivered 40 Gy in a single fraction, or for HSRT, the equivalent radiobiological fractionated dose a total of 72 Gy in six fractions. The target (the retrogasserian cisternal portion of the trigeminal nerve) was identified by fusion of CT scans with 1-mm-thick T2-weighted MRI, and the radiant dose was delivered by a 10-mm-diameter cylindrical collimator. The results were evaluated using the Barrow Neurological Institute pain scale during follow-up (mean 3.9 years). The 95% isodose was applied to the entire target volume. After RS (23 patients), Class 1 results were observed in 10 patients; Class II in nine, Class IIIa in two, Class IIIb in one, and Class V results in one patient. Facial numbness occurred in two (8.7%) patients, and the trigeminal neuralgia recurred in two patients (8.7%). Following HSRT (22 patients), Class I results were achieved in eight patients, Class II in eight, Class IIIa in four, and Class IIIb in two patients; recurrence occurred in six (27.5%), and there were no complications. Thus, both RS and HSRT provided effective and safe therapy for the treatment of trigeminal neuralgia. Patients who underwent RS experienced better pain relief and a lower recurrence rate, whereas those who underwent HRST had no side effects, and in particular, no facial numbness. (C) 2012 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1401 / 1403
页数:3
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