Effect of beam channel plugging on the outcome of gamma knife radiosurgery for trigeminal neuralgia.

Details

Serval ID
serval:BIB_7AC306CA9E6D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effect of beam channel plugging on the outcome of gamma knife radiosurgery for trigeminal neuralgia.
Journal
International Journal of Radiation Oncology, Biology, Physics
Author(s)
Massager N., Nissim O., Murata N., Devriendt D., Desmedt F., Vanderlinden B., Régis J., Levivier M.
ISSN
0360-3016 (Print)
ISSN-L
0360-3016
Publication state
Published
Issued date
2006
Peer-reviewed
Oui
Volume
65
Number
4
Pages
1200-1205
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
PURPOSE: We studied the influence of using plugs for brainstem protection during gamma knife radiosurgery (GKR) of trigeminal neuralgia (TN), with special emphasis on irradiation doses delivered to the trigeminal nerve, pain outcomes, and incidence of trigeminal dysfunction.
METHODS AND MATERIALS: A GKR procedure for TN using an anterior cisternal target and a maximum dose of 90 Gy was performed in 109 patients. For 49 patients, customized beam channel blocking (plugs) were used to reduce the dose delivered to the brainstem. We measured the mean and integrated radiation doses delivered to the trigeminal nerve and the clinical course of patients treated with and without plugs.
RESULTS: We found that blocking increases the length of trigeminal nerve exposed to high-dose radiation, resulting in a significantly higher mean dose to the trigeminal nerve. Significantly more of the patients with blocking achieved excellent pain outcomes (84% vs. 62%), but with higher incidences of moderate and bothersome trigeminal nerve dysfunction (37% mild/10% bothersome with plugs vs. 30% mild/2% bothersome without).
CONCLUSIONS: The use of plugs to protect the brainstem during GKR treatment for TN increases the dose of irradiation delivered to the intracisternal trigeminal nerve root and is associated with an important increase in the incidence of trigeminal nerve dysfunction. Therefore, beam channel blocking should be avoided for 90 Gy-GKR of TN.
Keywords
Adult, Aged, Aged, 80 and over, Brain Stem/radiation effects, Female, Follow-Up Studies, Humans, Male, Middle Aged, Radiation Injuries/prevention & control, Radiosurgery/methods, Radiotherapy Dosage, Trigeminal Neuralgia/surgery
Pubmed
Web of science
Create date
20/01/2008 17:35
Last modification date
20/08/2019 14:36
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