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Effectiveness and safety of CyberKnife radiosurgery in treatment of trigeminalgia — experiences of Polish neurological and oncological centres
, 2
Affiliations- Department of Outpatient Chemotherapy, Maria Skłodowska-Curie, Memorial Cancer Center and Institute of Oncology, Gliwice, Poland, Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland
- Department of Neurology, Medical University of Silesia, School of Health Sciences, Ziołowa 45/47, 40-635 Katowice, Poland
- Department of Basic Medical Sciences, School of Health Sciences in Bytom, Medical University of Silesia, Katowice, Poland,, Poniatowskiego 15, 40-055 Katowice, Poland
- III Department of Radio- and Chemotherapy, Maria Skłodowska-Curie, Memorial Cancer Center and Institute of Oncology, Wybrzeże Armii Krajowej 15, 44-101 Gliwice, Poland
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Abstract
Trigeminal neuralgia (TN) is one of the most common cranial neuropathies. Pathologies located alongside the long nerve can also cause its mechanical compression or secondary involvement in the inflammatory process, and thus cause pain. TN is characterised by severe paroxysmal unilateral facial pain in the innervation area of branches I-III of the nerve V when provoked by light touch or slight movement. Multiple therapeutic methods are available, but most of them yield unsatisfactory results. According to guidelines (AAN and EFNS) the first-line therapy in trigeminalgia is carbamazepine/oxcarbazepine, and if there is a poor response — surgical treatment [1]. The array of surgical options includes percutaneous retrogasserian glycerol injection, radiofrequency thermocoagulation, balloon decompression, thermal rhizotomy, and stereotactic radiosurgery [2–4]. This paper presents our own experiences with CyberKnife (CK), a new type of radiosurgical (RS) treatment of 64 TN patients. Conclusions. CyberKnife radiotherapy is characterised by high efficacy in 80% of patients with trigeminalgia, minimal invasiveness, and subsiding mild side effects. Radioablation of nerve V root in patients with neuralgia allows us to entirely stop antiepileptic therapy or reduce its doses, which in turn reduces the risk of potential side effects. CyberKnife can be a therapeutic option in those patients who have been offered ineffective therapies, or treatments with limited efficacy, and/or in older patients with comorbidities.
Abstract
Trigeminal neuralgia (TN) is one of the most common cranial neuropathies. Pathologies located alongside the long nerve can also cause its mechanical compression or secondary involvement in the inflammatory process, and thus cause pain. TN is characterised by severe paroxysmal unilateral facial pain in the innervation area of branches I-III of the nerve V when provoked by light touch or slight movement. Multiple therapeutic methods are available, but most of them yield unsatisfactory results. According to guidelines (AAN and EFNS) the first-line therapy in trigeminalgia is carbamazepine/oxcarbazepine, and if there is a poor response — surgical treatment [1]. The array of surgical options includes percutaneous retrogasserian glycerol injection, radiofrequency thermocoagulation, balloon decompression, thermal rhizotomy, and stereotactic radiosurgery [2–4]. This paper presents our own experiences with CyberKnife (CK), a new type of radiosurgical (RS) treatment of 64 TN patients. Conclusions. CyberKnife radiotherapy is characterised by high efficacy in 80% of patients with trigeminalgia, minimal invasiveness, and subsiding mild side effects. Radioablation of nerve V root in patients with neuralgia allows us to entirely stop antiepileptic therapy or reduce its doses, which in turn reduces the risk of potential side effects. CyberKnife can be a therapeutic option in those patients who have been offered ineffective therapies, or treatments with limited efficacy, and/or in older patients with comorbidities.
Keywords
trigeminal neuralgia, CyberKnife, radiosurgery
About this articleTitle
Effectiveness and safety of CyberKnife radiosurgery in treatment of trigeminalgia — experiences of Polish neurological and oncological centres
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Review Article
Pages
28-32
Published online
2020-01-23
Page views
1996
Article views/downloads
600
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2020;54(1):28-32.
Keywords
trigeminal neuralgia
CyberKnife
radiosurgery
Authors
Wiesław Bal
Beata Łabuz- Roszak
Rafał Tarnawski
Anetta Lasek-Bal
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