| Efficacy of CyberKnife RadioSurgery with CT Cisternography Planning in Management of Patients with Trigeminal Neuralgia |
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Gang-Hyuk Park, Tae-Kyu Lee, Jong-Hyun Kim, Sang-Bok Lee, Do-Sung Yoo, Pil-Woo Huh, Kyung-Souk Cho |
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Department of Neurosurgery, Uijeongbu St Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea |
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| Abstract |
Purpose
: We retrospectively analyzed the outcome of 38 patients with medically intractable Trigeminal Neuralgia (TN) to evaluate whether CyberKnife Radio Surgery (CKRS) with Computer Tomography (CT) cisternography planning is an effective and safe mode of therapy.
Methods
and Materials : Since March 2004, 38 patients with trigeminal neuralgia were treated by CKRS and a CT cisternography to obtain a distortion-free localization of the trigeminal nerve. The trigeminal nerve 3-5mm long was the target with the exception of the most proximal point of the trigeminal nerve. Treatment planning was established to the end that radiation targets could be all included in the 80-percent isodose curve with radiosurgery doses of 60-64Gy. The median follow-up period after CKRS was 36 months (24-48months).
Results
: The results of pain relief in 38 patients with TN after CKRS with CT cisternography planning showed that pain relief was achieved in 18 patients within the first 24 hrs after treatment. Within 7 days, 34 of the 38 study patients reported early pain relief. The pain control rate was 68% at follow up of 24months. Pain relapsed in eight patients of 38. Twelve patients had hyperesthesia (32%) with no other complication.
Conclusions
: We believe that CKRS is safe and effective treatment for the patients with TN in this study. The pains of most patients were alleviated within 7 days after the CKRS with CT cisternography planning. Such a phenomenon may be explained with the high accuracy of irradiation and another merit that the best conformity can be made along the trigeminal nerve. |
| Key Words:
Trigeminal neuralgia, CyberKnife, Radiosurgery. |
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