Gamma knife radiosurgery in the treatment of tumor-related facial pain

Sarah E. Squire, Michael D. Chan, R. Michael Furr, Dorothy A. Lowell, Stephen B. Tatter, Thomas L. Ellis, J. Daniel Bourland, Allan F. Deguzman, Michael T. Munley, Kenneth E. Ekstrand, Edward G. Shaw, Kevin P. McMullen

Research output: Contribution to journalReview article

12 Scopus citations

Abstract

Background: Intracranial neoplasms can cause pain similar to trigeminal neuralgia. Literature regarding radiosurgery for this is limited. We present a retrospective review of patients with tumor-related facial pain from benign lesions treated with gamma knife radiosurgery (GKRS) at Wake Forest University. Objectives: The primary objectives were to determine long-term pain relief and predictive factors for pain alleviation. Methods: We reviewed 515 patients treated with GKRS for benign meningioma, vestibular schwannoma or trigeminal schwannoma between August 1999 and August 2010. Twenty-one eligible patients had tumor-related facial pain prior to GKRS. The median marginal tumor dose was 12 Gy. Long-term pain relief data were obtained by chart review and telephone interview. Results: The median follow-up for symptom evaluation was 3.8 years. Seventeen of 21 patients (81%) experienced a Barrow Neurological Institute (BNI) score of I-III at 6 months following GKRS. Kaplan-Meier estimates of freedom from BNI IV-V relapse were 66% at 1 year and 53% at 2 years. No pain relapses occurred after 2 years. Conclusion: GKRS of benign lesions is a noninvasive option for patients with tumor-related facial pain. Pain relief is modest, with the majority of pain relapses occurring within 2 years and approximately one half of patients maintaining relief beyond 2 years.

Original languageEnglish (US)
Pages (from-to)145-150
Number of pages6
JournalStereotactic and functional neurosurgery
Volume90
Issue number3
DOIs
StatePublished - Jun 1 2012

Keywords

  • Benign lesions
  • Facial pain
  • Gamma knife radiosurgery
  • Intracranial tumors

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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    Squire, S. E., Chan, M. D., Furr, R. M., Lowell, D. A., Tatter, S. B., Ellis, T. L., Bourland, J. D., Deguzman, A. F., Munley, M. T., Ekstrand, K. E., Shaw, E. G., & McMullen, K. P. (2012). Gamma knife radiosurgery in the treatment of tumor-related facial pain. Stereotactic and functional neurosurgery, 90(3), 145-150. https://doi.org/10.1159/000335873