Study of the Pain Relief Time of Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia_West China Medical Journal

Authors：

ZHANG Zhujun , LI Yang ,  LI Peng , WANG Wei , REN Haibo

Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LI Peng, Email: zzj5265798@163.com

Keywords：

伽玛刀; 三叉神经痛; 疼痛缓解时间

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目的　分析和总结采用双靶点伽玛刀治疗三叉神经痛术后疼痛缓解时间规律，为伽玛刀的临床治疗提供参考。方法　2005年1月－2011年1月，共147例原发性三叉神经痛患者于四川大学华西医院接受Leksell C型伽玛刀治疗。使用4 mm准直器在三叉神经根制作2个等中心靶点，中心剂量80~90 Gy，控制脑桥照射剂量＜20 Gy。术后定期对患者进行随访，对疼痛缓解时间进行统计分析。结果　130例患者获得随访，随访时间11～64个月，平均28.7个月。术后疼痛完全缓解95例（73.1%），部分缓解29例（22.3%），无效6例（4.6%）。疼痛缓解时间4 h～12个月，平均3.6周，其中疼痛完全缓解患者的疼痛缓解时间明显短于部分缓解患者（P＜0.05）。53例（40.8%）患者于术后出现术侧轻度面部麻木。结论　患者术后疼痛缓解时间可能是预测伽玛刀治疗效果的重要因素，但疼痛缓解时间个体差异大，应进行长期随访观察。

Citation： ZHANG Zhujun,LI Yang,LI Peng,WANG Wei,REN Haibo. Study of the Pain Relief Time of Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia. West China Medical Journal, 2012, 27(6): 889-891. doi: Copy

1.	Rogers CL, Shetter AG, Fiedler JA, et al. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute[J]. Int J Radiat Oncol Biol Phys, 2000, 47(4): 1013-1019.
2.	Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management[J]. Eur J Neurol, 2008, 15(10): 1013-1028.
3.	Kondziolka D, Lunsford LD, Flickinger JC, et al. Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit[J]. J Neurosurg, 1996, 84(6): 940-945.
4.	Brisman R. Gamma knife radiosurgery for primary management for trigeminal neuralgia[J]. J Neurosurg, 2000, 93(Suppl 3): 159-161.
5.	Petit JH, Herman JM, Nagda S, et al. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1147-1153.
6.	赵洪洋, 童萼塘, 赵沃华. 原发性三叉神经痛的伽玛刀双靶点治疗[J]. 中华神经外科杂志, 2005, 21(4): 216-219.
7.	Maesawa S, Salame C, Flickinger JC, et al. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2001, 94(1): 14-20.
8.	Longhi M, Rizzo P, Nicolato A, et al. Gamma knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters-partⅠ: idiopathic trigeminal neuralgia[J]. Neurosurgery, 2007, 61(6): 1254-1260.
9.	宗建海, 刘华峰, 董玉霞, 等. 伽玛刀治疗原发性三叉神经痛的疗效[J]. 中国微创外科杂志, 2010, 16(4): 365-367.
10.	方俊杰, 赵洪洋, 杨卫忠. 伽玛刀双靶点治疗原发性三叉神经痛的临床研究[J]. 中国神经精神疾病杂志, 2009, 35(6): 339-341.
11.	Pollock BE, Phuong LK, Gorman DA, et al. Stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2002, 97(2): 347-353.
12.	Tawk RG, Duffy-Fronckowiak M, Scott BE, et al. Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response[J]. J Neurosurg, 2005, 102(3): 442-449.
13.	Marshall K, Chan MD, McCoy TP, et al. Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery[J]. Neurosurgery, 2012, 70(3): 566-573.
14.	Yen CP, Schlesinger D, Sheehan JP, et al. Gamma Knife® radiosurgery for trigeminal neuralgia[J]. Expert Rev Med Devices, 2011, 8(6): 709-721.
15.	Park SH, Hwang SK. Outcomes of gamma knife radiosurgery for trigeminal neuralgia after a minimum 3-year follow-up[J]. J Clin Neurosci, 2011, 18(5): 645-648.

1. 　Rogers CL, Shetter AG, Fiedler JA, et al. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute[J]. Int J Radiat Oncol Biol Phys, 2000, 47(4): 1013-1019.
2. 　Cruccu G, Gronseth G, Alksne J, et al. AAN-EFNS guidelines on trigeminal neuralgia management[J]. Eur J Neurol, 2008, 15(10): 1013-1028.
3. 　Kondziolka D, Lunsford LD, Flickinger JC, et al. Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit[J]. J Neurosurg, 1996, 84(6): 940-945.
4. 　Brisman R. Gamma knife radiosurgery for primary management for trigeminal neuralgia[J]. J Neurosurg, 2000, 93(Suppl 3): 159-161.
5. 　Petit JH, Herman JM, Nagda S, et al. Radiosurgical treatment of trigeminal neuralgia: evaluating quality of life and treatment outcomes[J]. Int J Radiat Oncol Biol Phys, 2003, 56(4): 1147-1153.
6. 　赵洪洋, 童萼塘, 赵沃华. 原发性三叉神经痛的伽玛刀双靶点治疗[J]. 中华神经外科杂志, 2005, 21(4): 216-219.
7. 　Maesawa S, Salame C, Flickinger JC, et al. Clinical outcomes after stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2001, 94(1): 14-20.
8. 　Longhi M, Rizzo P, Nicolato A, et al. Gamma knife radiosurgery for trigeminal neuralgia: results and potentially predictive parameters-partⅠ: idiopathic trigeminal neuralgia[J]. Neurosurgery, 2007, 61(6): 1254-1260.
9. 　宗建海, 刘华峰, 董玉霞, 等. 伽玛刀治疗原发性三叉神经痛的疗效[J]. 中国微创外科杂志, 2010, 16(4): 365-367.
10. 　方俊杰, 赵洪洋, 杨卫忠. 伽玛刀双靶点治疗原发性三叉神经痛的临床研究[J]. 中国神经精神疾病杂志, 2009, 35(6): 339-341.
11. 　Pollock BE, Phuong LK, Gorman DA, et al. Stereotactic radiosurgery for idiopathic trigeminal neuralgia[J]. J Neurosurg, 2002, 97(2): 347-353.
12. 　Tawk RG, Duffy-Fronckowiak M, Scott BE, et al. Stereotactic gamma knife surgery for trigeminal neuralgia: detailed analysis of treatment response[J]. J Neurosurg, 2005, 102(3): 442-449.
13. 　Marshall K, Chan MD, McCoy TP, et al. Predictive variables for the successful treatment of trigeminal neuralgia with gamma knife radiosurgery[J]. Neurosurgery, 2012, 70(3): 566-573.
14. 　Yen CP, Schlesinger D, Sheehan JP, et al. Gamma Knife® radiosurgery for trigeminal neuralgia[J]. Expert Rev Med Devices, 2011, 8(6): 709-721.
15. 　Park SH, Hwang SK. Outcomes of gamma knife radiosurgery for trigeminal neuralgia after a minimum 3-year follow-up[J]. J Clin Neurosci, 2011, 18(5): 645-648.

West China Medical Journal

Study of the Pain Relief Time of Gamma Knife Radiosurgery for Idiopathic Trigeminal Neuralgia

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