ESTRO 2024 - Abstract Book

S854

Clinical - CNS

ESTRO 2024

Title: Gamma Knife Radiosurgery for Trigeminal Neuralgia: A review of 59 patients

Juan B Cortina, Julieta M Silva, Gonçalo Fernandes, Begoña Cattoni, Jose Manuel Brás

Cuf, GammaKnife, Lisbon, Portugal

Purpose/Objective:

Several potentially successful surgical modalities are available to patients with medically

refractory Trigeminal Neuralgia (TN). Gamma Knife (GK) is an established therapeutic option

for patients with TN. A handful of studied have shown the efficacy of GK but de follow-up

has been short. We report a retrospective review of 59 patients with a median follow-up of

60 months.

Material/Methods:

A retrospective review was conducted for 59 patients who underwent GK for refractory TN

at our institution between 2010 and 2023. TN received GK with a mean marginal radiation

dose of 42,5 Gy applied to an average isodose line of 50% of the affected trigeminal nerve.

Follow-up data were obtained by clinical examination and telephone questionnaire.

Outcomes results were evaluated using the Barrow Neurological Institute (BNI) Pain Scale.

BNI I-III was considered to be a good outcome and BNI IV-V considered a treatment failure.

Results:

The median follow-up was 60 months. Of the total 59 patients, 30 (50,8%) had good

outcomes, reported as pain relief within 1 month following de GK treatment. A total of 8

patients (13,6%) experienced complete pain relief off medications (BIN I). At median follow-

up of 60 months, the actuarial rate of freedom from severe pain (BIN>=III) was 27,1%.

21 patients were subjected to a previous surgical treatment. 14 patients were taking more than 3 drugs.

5 patients developed new or increased facial paresthesias after radiosurgery (12,2%).

Conclusion: