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REVIEW ARTICLE
was associated with both brainstem
There was a trend for female gender and trigeminal length of treated nerve bothersome facial numbness (p=0.06). None of the patients had any additional late central-nervous-system toxicities.
On review, we saw an association between radiographic vascular compromise (defined as having a visible blood vessel crossing the trigeminal nerve on CISS images) and a decreased risk of pain relapse when using the fractionated technique. This is possibly due to the trigeminal nerve healing faster than the simultaneously ablated blood vessel between doses.
REFERENCES
CONCLUSIONS
CyberKnife SRS is a non-invasive and effective treatment of medically and surgically intractable trigeminal neuralgia patients’ facial pain. The main late toxicity is facial numbness, which is preferable in the vast majority of patients to TN pain.
Our novel technique of fractionating the radiosurgery dose allows us to give a higher dose to the trigeminal nerve while minimizing the risk of facial numbness. Our published abstract establishes dosimetric parameters to minimize the risk of facial numbness when using three consecutive fractions. This method is most high-resolution MRI.
CONTRIBUTING AUTHORS
■ Sohan Shah graduated from the Charter School of Wilmington and is currently a major in Neuroscience at Johns Hopkins University in Baltimore, MD.
■ Serguei Castaneda, MD is the Chief Resident in Radiation Oncology at the Helen F. Graham Cancer Center in Newark.
■ Matthew Dzeda graduated from Garnet Valley High School in Glen Mills, PA. He plans to graduate in April 2020 with a BS in Chemistry and a Spanish minor at the University of Pittsburgh.
■ Sunjay Shah, MD is a Radiation Oncologist at the Helen F. Graham Cancer Center at ChristianaCare. He completed a fellowship in Brain Radiosurgery at the Thomas Jefferson University Hospital in Philadelphia and was the Founding Director of the CyberKnife program.
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