ESTRO 2025 - Abstract Book

S662

Clinical - CNS

ESTRO 2025

and meta-regressions were used to examine the association between dose-rate and pain relief in TN following GKRS.

Results: Of 6,950 citations, 13 publications reporting on 12 cohort studies of 3,196 patients who underwent GKRS for TN (n=5), vestibular schwannoma (n=3), arteriovenous malformation (n=2), and meningioma (n=1) were included. Higher dose-rates were positively correlated with treatment response and tumor control. Meta-analysis of TN studies demonstrated higher dose-rates were associated with higher rates of pain relief with low certainty of evidence [relative risk (RR) [95% CI] = 1.36 [1.10-1.67], p =0.005] (Figure 1). Meta-regression demonstrated an estimated 26% increase in chance for pain control for each 1 Gy/min increase in median dose-rate (β [95% CI] = 0.26 [-1.09, 1.60], p=0.71) (Figure 2). Figure 1. Meta-analysis forest plot for pain relief among TN patients; risk ratio for pain relief in relation to higher dose-rates.

Figure 2. Relationship of pain relief and dose-rate among patients in the four trigeminal neuralgia studies. Data points represent the median dose-rate value assigned to endpoint category (high dose-rate) and reference category (low dose-rate) and the corresponding risk ratio of comparison with the reference category. A line of best fit describes the average relationship.