Determination of a Clinical Value for the Repair Half-Time (<i>T</i><sub>1/2</sub>) of the Trigeminal Nerve Based on Outcome Data from Gamma Knife Radiosurgery for Facial Pain

Stieber, Volker W.; Robbins, Michael E.; Balamucki, Christopher J.; deGuzman, Allan F.; Tatter, Stephen B.; Ekstrand, Kenneth E.; McMullen, Kevin P.; Branch, Charles L.; Shaw, Edward G.; Bourland, J. Daniel; Lovato, James; Munley, Michael T.; Ellis, Thomas L.

doi:10.1667/rr0620.1

Cited by 2 publications

(3 citation statements)

References 27 publications

(28 reference statements)

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“…However, possibly because it is frequently assumed that this is a single dose therapy, the incorporation of incomplete repair parameters into the model, has to the knowledge of the authors, only been proposed by two groups [3,23,24]. This was in the form of the use a single repair halftime, even though evidence from conventional radiotherapy has indicated the inherent dangers of this approach.…”

Section: Discussionmentioning

confidence: 99%

“…However, the data provided in the manuscript do not allow the treatment times of these patients to be clearly identified for the purpose of calculation. Although the group of authors reporting on the analysis based on the use of patients treated with trigeminal neuralgia subsequently revised the value of the halftime for repair to between 1.28-1.77 h [24], the inherent danger of the use of a single repair parameter, even of this magnitude, have already been shown to be inadequate for the calculation of equivalent doses with the variations in treatment protocols currently used in Gamma Knife radio-surgery.…”

Section: Discussionmentioning

confidence: 99%

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Radiobiological Principles: Their Application to Gamma Knife Therapy

Hopewell

Millar

Lindquist

2012

Progress in Neurological Surgery

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Gamma Knife treatments are regarded as single dose exposures, however, in reality the total dose delivered is the addition of a variable number of individual smaller doses from the variable number of iso-centres or shots, selected to cover a lesion. The dose prescription, in terms of dose and dose rate, to different points on a given physical iso-surface, will vary according to location. In radiobiological terms this treatment pattern does not represent a single exposure, but a schedule with a variable number of different sized dose fractions given at different dose rates with multiple incompletes repair intervals (the time between shots). Using the concept of biologically effective dose (BED), incorporating a fast and a slow component of repair, the biological effectiveness of a 12-shot protocol was found to vary with the decay in the activity of the (60)Co sources and the time interval between shots. However, the largest effect was found when this standard protocol was compared with one involving only 2 shots. It should be recognised in individual Gamma Knife treatments that there are many variables which have the potential to influence the biological effective of the treatment and thus the importance of a single variable may be difficult to determine in isolation. Reports in the literature support the results of these simulated calculations into the factors likely to change the biologically effective dose with the use of the Gamma Knife.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Radiobiological Principles: Their Application to Gamma Knife Therapy

Hopewell

Millar

Lindquist

2012

Progress in Neurological Surgery

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“…Initial reports of SRS safety and side effects were derived from animal models and other types of brain irradiation 22,26,49,59,126 . More recently, models for predicting the likelihood of complications after SRS came to be based on actual clinical experience 55,80,133,155 .…”

Section: Factors Influencing Complicationsmentioning

confidence: 99%

The Downside of Radiosurgery, Possible Complications

Pereira¹,

Modesto²

2018

jbnc

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As a consequence of various last century scientific and technological advances radiotherapy and stereotactic radiosurgery (SRS) have emerged as safe and efficacious techniques for the treatment of various intracranial pathologies. Recent improvements such as in brain and tumor imaging, patient immobilization, 3D planning and radiation delivery allow it to target lesions more accurately and minimize radiation delivered to normal brain, leading to drastic improvements in terms of safety and post-therapy complication. Despite that SRS still implies in moderate to severe side effects in one fifth to one fourth of patients. Fortunately the most common SRS complications, such as edema, blood brain barrier breakdown and MRI abnormalities are self-limited and amenable to treatment. The precise pathophysiological processes of SRS complications are still under research, however multiple factors including treatment dose, modality and planning complexity, target size, shape and location are known to affect treatment results. The most reported potential SRS complications are ischemic stroke, brain or lesion hemorrhage, radiosurgeryinduced neoplasm, radiation necrosis, white matter changes, cranial nerve dysfunction and cognition problems. SRS induced neurological complications may persist only in as much as 5% of patients.

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Determination of a Clinical Value for the Repair Half-Time (T_1/2) of the Trigeminal Nerve Based on Outcome Data from Gamma Knife Radiosurgery for Facial Pain

Cited by 2 publications

References 27 publications

Radiobiological Principles: Their Application to Gamma Knife Therapy

Radiobiological Principles: Their Application to Gamma Knife Therapy

The Downside of Radiosurgery, Possible Complications

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Determination of a Clinical Value for the Repair Half-Time (T1/2) of the Trigeminal Nerve Based on Outcome Data from Gamma Knife Radiosurgery for Facial Pain

Cited by 2 publications

References 27 publications

Radiobiological Principles: Their Application to Gamma Knife Therapy

Radiobiological Principles: Their Application to Gamma Knife Therapy

The Downside of Radiosurgery, Possible Complications

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Product

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Determination of a Clinical Value for the Repair Half-Time (T_1/2) of the Trigeminal Nerve Based on Outcome Data from Gamma Knife Radiosurgery for Facial Pain