The Role of Internationally Standardized Radiosurgery Treatment Parameters in Predicting Long-Term Trigeminal Neuralgia Outcomes

Marchan, Edward M.; Vender, John R.; Cantrell, Rebecca; Alleyne, Cargill H.; Norris, C.; Madden, N.A.; Marascio, J.A.; Rabatic, B.M.; Zaenger, D.; Al-Basheer, A.; Aletan, M.; Amoush, A.; Pishgou, M.; Ferguson, C.L.; Huang, Keyong; Shaaban, Sherif G.; Green, A.; Mott, Frank E.; Figueroa, Ramón; Mourad, W.F.

doi:10.1016/j.ijrobp.2016.06.442

Cited by 3 publications

(2 citation statements)

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“…In terms of the time to obtain favorable outcomes, the MVD group was significantly more rapid and better than the GKRS group, for which the principles of the two technologies for relieving neurovascular conflicts completely differ. MVD surgery maintains a space between the trigeminal nerve and the responsible blood vessel, which can effectively interrupt the transmission of pulse force and free the trigeminal nerve from any contact, thus eliminating the abnormal discharge caused by the formation of a short circuit and stop the onset of pain ( 47 , 48 ). The principle of two-isocenter GKRS is not only to conform to the trigeminal nerve root but also to increase the irradiated volume of the trigeminal nerve, so that the axons are fully degenerated and decomposed.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

et al. 2021

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Background: Vertebrobasilar dolichoectasia (VBD) is one of the rare causes of trigeminal neuralgia (TN). The common surgical treatments for patients with TN caused by VBD (VBD-TN) are microvascular decompression (MVD) and Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically compared, so this study was performed to evaluate the treatment outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study was performed from March 2011 to March 2019 in Wuhan Union Hospital. A total of 80 patients diagnosed with VBD-TN were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. The imaging data, intraoperative findings, treatment outcomes, and complications of the two groups were analyzed and compared. Meanwhile, the influencing factors of the treatment effect are also explored on the two groups.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, respectively, p = 0.03). The median follow-up was 61.1 months for the MVD group and 56.8 months for the GKRS group. The favorable outcomes [Barrow Neurological Institute (BNI) pain score, BNI scores I–II] occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (p = 0.009). The favorable outcomes in the percentage of patients after MVD 1, 3, 5, and 7 years were 95.7, 85.1, 74.2, and 74.2%, respectively, whereas the corresponding percentages after GKRS were 76.5, 66.2, 56.6, and 47.2%, respectively (p = 0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (p = 0.036), but the incidence of new and worsening facial numbness was lower in the GKRS group (p < 0.001).Conclusions: MVD is superior to GKRS in obtaining and maintaining favorable outcomes for patients with VBD-TN, but it also comes with more complications other than facial numbness. Thus, the treatment program can be tailored to a patient's unique condition and wishes.

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Section: Discussionmentioning

confidence: 99%

Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

et al. 2021

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show abstract

“…MVD surgery maintains a space between the trigeminal nerve and the responsible blood vessel, which can effectively interrupt the transmission of pulse force and free the trigeminal nerve from any contact. Thus eliminating the abnormal discharge caused by the formation of a short circuit between the blood vessel and the exposed myelin axon and stopping the onset of pain [31,46]. The principle of two isocenters GKRS is not only to conform to the trigeminal nerve root but also to increase the irradiated volume of the trigeminal nerve, so that the axons are fully degenerated and decomposed.…”

Section: Discussionmentioning

confidence: 99%

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

Zhao

Chai

Wang

et al. 2021

Preprint

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Objective: Vertebrobasilar dolichoectasia (VBD) is one of the uncommon causes of trigeminal neuralgia (TN). The main surgical treatments for TN caused by VBD (VBD-TN) are invasive microvascular decompression (MVD) and mini-invasive Gamma Knife radiosurgery (GKRS). However, the therapeutic effects of the two methods have not been clinically reported, so this study evaluated the outcomes of MVD and GKRS for patients with VBD-TN.Methods: The retrospective study of patients diagnosed with VBD-TN in Wuhan Union Hospital was performed from March 2011 to March 2019. A total of 80 patients were included in this study, and they were divided into the MVD group (n = 46) and GKRS group (n = 34) according to the surgical methods. Among patients in the GKRS group, all performed by two isocenters gamma knife. The imaging data, intraoperative findings, outcomes, and complications of the two groups were analyzed and compared.Results: Patients who underwent MVD were younger than patients who underwent GKRS (median ages were 61.1 and 65.4 years old, p=0.03). The average follow-up was 61.1 months for the MVD group and was 56.8 months for the GKRS group. The favorable outcomes (BNI score I-II) occurred in 97.8% of patients treated with MVD and in 78.9% of patients treated with GKRS (P=0.009). The favorable outcomes in the percentage of patients after MVD 1,3,5 and 7 years were 95.7%, 85.1%, 74.2%, and 74.2%. The corresponding percentages after GKRS were 76.5%, 66.2%, 56.6% and 47.2%, respectively (P=0.031). The postoperative complications (except facial numbness) in the MVD group were higher than those in the GKRS group (P=0.036), but the incidence of new and worsening facial numbness was higher in the GKRS group (P<0.001).Conclusions: For VBD-TN, MVD is superior to GKRS in obtaining and maintaining favorable outcomes, but it also comes with more complications other than facial sensation. Treatment choice can be tailored to a patient’s unique condition and wishes.

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The Impact of Dose Escalation Upon Cost Reduction Following Stereotactic Radiosurgery for Trigeminal Neuralgia

Miller

Kotecha

Barnett

et al. 2016

International Journal of Radiation Oncology*Biology*Physics

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The Role of Internationally Standardized Radiosurgery Treatment Parameters in Predicting Long-Term Trigeminal Neuralgia Outcomes

Abstract: Conclusion: In a large cohort of community and academic patients, we did not find an independent association between radiation treatment schedule and OS in early stage NSCLC patients. Our findings suggest that dose escalation beyond 100 Gy BED 10 may improve patient survival.

Cited by 3 publications

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Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

Comparison of Microvascular Decompression and Two Isocenters Gamma Knife for the Treatment of Trigeminal Neuralgia Caused by Vertebrobasilar Dolichoectasia

Comparison of microvascular decompression and two isocenters gamma knife for the treatment of trigeminal neuralgia caused by vertebrobasilar compression

The Impact of Dose Escalation Upon Cost Reduction Following Stereotactic Radiosurgery for Trigeminal Neuralgia

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