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LONG-TERM OUTCOME OF GAMMA KNIFE RADIOSURGERY FOR TREATMENT OF TYPICAL TRIGEMINAL NEURALGIA

Cited 34 time in Web of Science Cited 30 time in Scopus
Authors
Han, Jung Ho; Kim, Dong Gyu; Chung, Hyun-Tai; Paek, Sun Ha; Kim, Chae-Yong; Kim, Young-Hoon; Jeong, Sang Soon; Kim, Jin Wook; Kim, Yong Hwy
Issue Date
2009-11-01
Publisher
ELSEVIER SCIENCE INC
Citation
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS; Vol.75 3; 822-827
Keywords
Trigeminal neuralgiaRadiosurgeryLong-term outcomeGamma knife
Abstract
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.
ISSN
0360-3016
Language
English
URI
https://hdl.handle.net/10371/77054
DOI
https://doi.org/10.1016/j.ijrobp.2008.11.046
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College of Medicine/School of Medicine (의과대학/대학원)Neurosurgery (신경외과학전공)Journal Papers (저널논문_신경외과학전공)
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