Koca S, Distel L, Lubgan D, Weissmann T, Lambrecht U, Lang-Welzenbach M, Eyüpoglu IY, Bischoff B, Buchfelder M, Semrau S, Fietkau R, Lettmaier S, Putz F (2019)
Publication Type: Journal article
Publication year: 2019
Book Volume: 195
Pages Range: 745-755
Journal Issue: 8
DOI: 10.1007/s00066-019-01450-9
Purpose: To prospectively evaluate the time course of pain response and toxicity after linear accelerator-based whole-nerve-encompassing radiosurgery (LINAC-SRS) using a uniform treatment schedule for dosing and target volume definition in patients with refractory trigeminal neuralgia. Methods: From December 2012 to December 2016, 21 patients were treated using a standardized protocol. Patients received LINAC-SRS with 70 Gy to the cisternal portion while aiming for the 90% isodose to fully envelope the nerve in one cross-sectional plane. Data on pain, analgesics, and toxicity were gathered prospectively. Four time intervals (1–6, 6–12, 12–18, and 18–24 months) were defined and compared to baseline and each other. Results: The median follow-up from radiotherapy was 16 months. Freedom from pain was achieved at least once in 90.5, 81.0, and 85.7% of patients for everyday pain, rest pain, and pain peaks, respectively. At 1–6 months, pain was significantly reduced in everyday routine (mean VAS, 2.0/10 vs. 5.8/10; P = 0.004), at rest (1.5/10 vs. 4.0/10; P = 0.002), and for pain peaks (2.9/10 vs. 10/10; P < 0.001), as was the number of analgesics (mean 1.5 vs. 2.9; P < 0.001). No significant increase in pain or analgesics was observed for subsequent time intervals. At last follow-up, reduction in pain compared to baseline for everyday routine (2.1/10 vs. 5.8/10; P = 0.010) and for pain peaks (3.3/10 vs. 10/10; P < 0.001) was significant, whereas it was not for rest pain (1.8/10 vs. 3.9/10; P = 0.073). Most toxicities were related to trigeminal nerve impairment, with 42.9% reporting new-onset hypoesthesia at last follow-up. Conclusion: This study provides prospective data after whole nerve encompassing LINAC-SRS for trigeminal neuralgia. No significant pain relapse was observed.
APA:
Koca, S., Distel, L., Lubgan, D., Weissmann, T., Lambrecht, U., Lang-Welzenbach, M.,... Putz, F. (2019). Time course of pain response and toxicity after whole-nerve-encompassing LINAC-based stereotactic radiosurgery for trigeminal neuralgia—a prospective observational study. Strahlentherapie und Onkologie, 195(8), 745-755. https://dx.doi.org/10.1007/s00066-019-01450-9
MLA:
Koca, Selim, et al. "Time course of pain response and toxicity after whole-nerve-encompassing LINAC-based stereotactic radiosurgery for trigeminal neuralgia—a prospective observational study." Strahlentherapie und Onkologie 195.8 (2019): 745-755.
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