Ke Tang, Nan Zhang, Xiaodong Yuan, Liangzhao Chu, Zenghui Qian, Yang Li
{"title":"放射外科生物有效剂量对特发性三叉神经痛 1 型的三叉神经根分割和切片疗效:一项多中心回顾性队列研究。","authors":"Ke Tang, Nan Zhang, Xiaodong Yuan, Liangzhao Chu, Zenghui Qian, Yang Li","doi":"10.1016/j.wneu.2024.10.084","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The wide variability in the efficacy of Gamma Knife surgery (GKS) treating trigeminal neuralgia type 1 (TN1) has not been completely elucidated. We aimed to investigate the association between outcomes of TN1 and the radiosurgical biologically effective dose (BED) on the specific part of the trigeminal root.</p><p><strong>Methods: </strong>We performed a multicentre retrospective cohort study for 548 patients with refractory TN1 treated by GKS. BED-volume histogram was formed for the trigeminal root, responsible division within the trigeminal root affected by TN1, trigeminal root section adjacent to the root entry zone (S1) and brainstem to generate the maximum BED (D<sub>MaxBED</sub>), and the volume percentage enclosed by iso-BED 1000 Gy<sub>2.47</sub> (V%<sub>BED1000</sub>) as plan quality metrics. The outcomes included pain relief, recurrence, and complications. Logistic regression and Cox proportional hazards models were used to analyse BED parameters.</p><p><strong>Results: </strong>There were 344 (62.77%), 144 (26.28%), and 54 (9.85%) patients with Barrow Neurological Institute (BNI) pain relief class III within 1 month, recurrence, and facial hypoesthesia. Patient-level analysis screened V%<sub>BED1000</sub> of the trigeminal root associated with BNI class III within 1 month and recurrence. D<sub>MaxBED</sub> of the brainstem + V%<sub>BED1000</sub> of the S1 significantly predicted facial hypoesthesia. Division-level analysis showed that D<sub>MaxBED</sub> + V%<sub>BED1000</sub> of the responsible division significantly predicted BNI class III within 1 month and recurrence.</p><p><strong>Conclusions: </strong>The efficacy and safety of GKS treating TN1 may depend on the sufficient coverage of high BED on the division affected by pain and tolerated BED on the root entry zone.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"975-1001"},"PeriodicalIF":1.9000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Radiosurgical Biologically Effective Dose on Trigeminal Root Division and Section for Outcomes of Idiopathic Trigeminal Neuralgia Type 1: A Multicentre Retrospective Cohort Study.\",\"authors\":\"Ke Tang, Nan Zhang, Xiaodong Yuan, Liangzhao Chu, Zenghui Qian, Yang Li\",\"doi\":\"10.1016/j.wneu.2024.10.084\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The wide variability in the efficacy of Gamma Knife surgery (GKS) treating trigeminal neuralgia type 1 (TN1) has not been completely elucidated. We aimed to investigate the association between outcomes of TN1 and the radiosurgical biologically effective dose (BED) on the specific part of the trigeminal root.</p><p><strong>Methods: </strong>We performed a multicentre retrospective cohort study for 548 patients with refractory TN1 treated by GKS. BED-volume histogram was formed for the trigeminal root, responsible division within the trigeminal root affected by TN1, trigeminal root section adjacent to the root entry zone (S1) and brainstem to generate the maximum BED (D<sub>MaxBED</sub>), and the volume percentage enclosed by iso-BED 1000 Gy<sub>2.47</sub> (V%<sub>BED1000</sub>) as plan quality metrics. The outcomes included pain relief, recurrence, and complications. Logistic regression and Cox proportional hazards models were used to analyse BED parameters.</p><p><strong>Results: </strong>There were 344 (62.77%), 144 (26.28%), and 54 (9.85%) patients with Barrow Neurological Institute (BNI) pain relief class III within 1 month, recurrence, and facial hypoesthesia. Patient-level analysis screened V%<sub>BED1000</sub> of the trigeminal root associated with BNI class III within 1 month and recurrence. D<sub>MaxBED</sub> of the brainstem + V%<sub>BED1000</sub> of the S1 significantly predicted facial hypoesthesia. Division-level analysis showed that D<sub>MaxBED</sub> + V%<sub>BED1000</sub> of the responsible division significantly predicted BNI class III within 1 month and recurrence.</p><p><strong>Conclusions: </strong>The efficacy and safety of GKS treating TN1 may depend on the sufficient coverage of high BED on the division affected by pain and tolerated BED on the root entry zone.</p>\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":\" \",\"pages\":\"975-1001\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.10.084\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/11/14 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.10.084","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/11/14 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Radiosurgical Biologically Effective Dose on Trigeminal Root Division and Section for Outcomes of Idiopathic Trigeminal Neuralgia Type 1: A Multicentre Retrospective Cohort Study.
Objective: The wide variability in the efficacy of Gamma Knife surgery (GKS) treating trigeminal neuralgia type 1 (TN1) has not been completely elucidated. We aimed to investigate the association between outcomes of TN1 and the radiosurgical biologically effective dose (BED) on the specific part of the trigeminal root.
Methods: We performed a multicentre retrospective cohort study for 548 patients with refractory TN1 treated by GKS. BED-volume histogram was formed for the trigeminal root, responsible division within the trigeminal root affected by TN1, trigeminal root section adjacent to the root entry zone (S1) and brainstem to generate the maximum BED (DMaxBED), and the volume percentage enclosed by iso-BED 1000 Gy2.47 (V%BED1000) as plan quality metrics. The outcomes included pain relief, recurrence, and complications. Logistic regression and Cox proportional hazards models were used to analyse BED parameters.
Results: There were 344 (62.77%), 144 (26.28%), and 54 (9.85%) patients with Barrow Neurological Institute (BNI) pain relief class III within 1 month, recurrence, and facial hypoesthesia. Patient-level analysis screened V%BED1000 of the trigeminal root associated with BNI class III within 1 month and recurrence. DMaxBED of the brainstem + V%BED1000 of the S1 significantly predicted facial hypoesthesia. Division-level analysis showed that DMaxBED + V%BED1000 of the responsible division significantly predicted BNI class III within 1 month and recurrence.
Conclusions: The efficacy and safety of GKS treating TN1 may depend on the sufficient coverage of high BED on the division affected by pain and tolerated BED on the root entry zone.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS