The Gamma Knife Dose Rate Does Not Affect Outcomes Of Trigeminal Neuralgia Radiosurgery

Keywords: trigeminal neuralgia, dose, pain, outcome, radiosurgery

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     To determine whether the Leksell Gamma Knife dose rate affects the outcome of trigeminal neuralgia (TN) stereotactic radiosurgery (SRS).
     We studied 165 patients (female =103, male= 63) who had medically intractable TN. We used the U unit (80 Gy maximum dose, 4 mm collimator) between 1994 and 2005. 
     The Gamma knife output factor was determined as 0.8 and the dose rate (DR) varied from 1.21 Gy/minute to 3.74 Gy/minute (median= 2.0555 Gy/minute). Treatment time ranged from 26.73 – 95.11 minutes.
     Pain relief (BNI scores of I-IIIa) occurred in 72.3 % of patients in the LDRG compare to 80.7% of HDRG patients (p= 0.200). Median duration of pain relief control (better or equal to BNI  IIIa) was 52 months for LDRG and was 50 months for HDRG patients (p=0.403). Deafferentation symptoms (paresthesias) occurred 16.9% of LDRG and 14,5 % of HDRG patients (p=0.669), New or worsened trigeminal sensory loss occurred in14.5 % of LDRG and 19.3 % HDRG patients ( p=0.407).
     This is a retrospective study.
     In this study a varying Leksell Gamma Knife Dose rate of 1.21 Gy to 3.74 Gy/minute did not affect pain relief.
     Nor did the dos rate affect treatment related side effects in the management of TN.


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