CyberKnife stereotactic radiosurgical rhizotomy for refractory trigeminal neuralgia

Tang, Chi‐Tun; Chang, Steven D.; Tseng, Kuan-Yin; Liu, Mingying; Ju, Da‐Tong

doi:10.1016/j.jocn.2011.03.012

Cited by 19 publications

(16 citation statements)

References 37 publications

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“…Many investigators have already reported the utilization of Cyber knife for TN and the outcomes are comparable to LINAC-based SRS but with a longer average beam on time. The reduction of average BOT in FFF beams is an added advantage over Gamma Knife and Cyber knife treatments for TN [25][26][27][28]. Many studies have reported the advantage of using FFF beams for small target volumes in terms of treatment delivery and lower peripheral doses to OAR's [29][30][31][32][33][34].…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of 6 MV Flattening Filter Free and 6 MV Stereotactic Radiosurgery Beam Using 4 mm Conical Collimator for Trigeminal Neuralgia Radiosurgery

et al. 2018

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Background: The purpose of our study was to compare the dosimetric advantages of Flattening filter free (FFF) beams for trigeminal neuralgia patients using 4 mm conical collimators over previously treated patients with 6 MV SRS beam. Materials and Methods: A retrospective study was conducted for 5 TN patients who had been previously treated at our institution using frame-based, LINAC-based stereotactic radiosurgery (SRS) on Novalis Tx using 6 MV SRS beam were replanned on 6X FFF beams on Edge Linear accelerator with same beam angles and dose constraints using 4 mm conical collimator. The total number of monitor units along with the beam on time was compared for both Edge and Novalis Tx by redelivering the plans in QA mode of LINAC to compare the delivery efficiency. Plan quality was evaluated by homogeneity index (HI) and Paddick gradient index (GI) for each plan. We also analyzed the doses to brainstem and organ at risks (OARs). Results and Discussion: A 28% beam-on time reduction was achieved using 6X FFF when compared with 6X SRS beam of Novalis Tx. A sharp dose fall off with gradient index value of 3.4 ± 0.27 for 4 mm Varian conical collimator while 4.17 ± 0.20 with BrainLab cone. Among the 5 patients treated with a 4 mm cone, average maximum brainstem dose was 10.24 Gy for Edge using 6X FFF and 14.28 Gy for Novalis Tx using 6X SRS beam. Conclusion: The use of FFF beams improves delivery efficiency and conical collimator reduces dose to OAR' s for TN radiosurgery. Further investigation is warranted with larger sample patient data.

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Section: Discussionmentioning

confidence: 99%

Dosimetric Comparison of 6 MV Flattening Filter Free and 6 MV Stereotactic Radiosurgery Beam Using 4 mm Conical Collimator for Trigeminal Neuralgia Radiosurgery

et al. 2018

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“…Radiosurgical rhizotomy with CyberKnife has been reported as a safe and effective procedure in the treatment of trigeminal neuralgia refractory to conventional treatments and produces necrosis, mainly in the sensory fibers of the trigeminal nerve, cutting the pain circuit [10][11][12]. Ulcerations in the nasal region have been studied by different ear-nose-throat (ENT) and dermatology specialists without having been able to clarify the pathophysiology or the best way of treatment [13][14].…”

Section: Radiosurgical Treatmentmentioning

confidence: 99%

Trigeminal Trophic Syndrome Secondary to Refractory Trigeminal Neuralgia Treated with CyberKnife® Radiosurgery

Sallabanda¹,

Sallabanda²,

Barrientos³

et al. 2020

Cureus

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“…However, due to technical advancements in precise targeting, linear accelerator based radiosurgery, and robotic radiosurgery are employed to treat the Trigeminal nerve target as a noninvasive frameless procedure. [91011121314] CyberKnife (Accuray, Sunnyvale, USA) is a robotic radiosurgery unit which is used to treat both intracranial and extracranial lesions stereotactically.…”

Section: Introductionmentioning

confidence: 99%

Comparative analysis between 5 mm and 7.5 mm collimators in CyberKnife radiosurgery for trigeminal neuralgia

Sudahar¹,

Kurup²,

Murali³

et al. 2013

J Med Phys

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Trigeminal neuralgia (TN) is treated in CyberKnife (Accuray Inc, Sunnyvale, USA) with the 5 mm collimator whose dosimetric inaccuracy is higher than the other available collimators. The 7.5 mm collimator which is having less dosimetric uncertainty can be an alternative for 5 mm collimator provided the dose distribution with 7.5 mm collimator is acceptable. Aim of this study is to analyze the role of 7.5 mm collimator in CyberKnife treatment plans of TN. The treatment plans with 5 mm collimators were re-optimized with 7.5 mm collimator and a bi-collimator system (5 mm and 7.5 mm). The treatment plans were compared for target coverage, brainstem doses, and the dose to normal tissues. The target and brainstem doses were comparable. However, the conformity indices were 2.31 ± 0.52, 2.40 ± 0.87 and 2.82 ± 0.51 for 5 mm, bi-collimator (5mm and 7.5 mm), 7.5 mm collimator plans respectively. This shows the level of dose spillage in 7.5 mm collimator plans. The 6 Gy dose volumes in 7.5 mm plans were 1.53 and 1.34 times higher than the 5 mm plan and the bi-collimator plans respectively. The treatment time parameters were lesser for 7.5 mm collimators. Since, the normal tissue dose is pretty high in 7.5 mm collimator plans, the use of it in TN plans can be ruled out though the treatment time is lesser for these 7.5 mm collimator plans.

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CyberKnife stereotactic radiosurgical rhizotomy for refractory trigeminal neuralgia

Cited by 19 publications

References 37 publications

Dosimetric Comparison of 6 MV Flattening Filter Free and 6 MV Stereotactic Radiosurgery Beam Using 4 mm Conical Collimator for Trigeminal Neuralgia Radiosurgery

Dosimetric Comparison of 6 MV Flattening Filter Free and 6 MV Stereotactic Radiosurgery Beam Using 4 mm Conical Collimator for Trigeminal Neuralgia Radiosurgery

Trigeminal Trophic Syndrome Secondary to Refractory Trigeminal Neuralgia Treated with CyberKnife® Radiosurgery

Comparative analysis between 5 mm and 7.5 mm collimators in CyberKnife radiosurgery for trigeminal neuralgia

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