{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T00:08:31Z","timestamp":1790208511714,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,2,28]],"date-time":"2017-02-28T00:00:00Z","timestamp":1488240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2017,3]]},"abstract":"Abstract<\/jats:title>\n \n Purpose\/Objectives<\/jats:title>\n \n To present our linac\u2010based\n SRS<\/jats:styled-content>\n procedural technique for medically and\/or surgically refractory trigeminal neuralgia (\n TN<\/jats:styled-content>\n ) treatment and simultaneously report our clinical outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n Twenty\u2010seven refractory\n TN<\/jats:styled-content>\n patients who were treated with a single fraction of 80 Gy to\n TN<\/jats:styled-content>\n . Treatment delivery was performed with a 4 mm cone size using 7\u2010arc arrangement with differential\u2010weighting for Novalis\u2010\n TX<\/jats:styled-content>\n with six\n MV<\/jats:styled-content>\n \u2010\n SRS<\/jats:styled-content>\n (1000\n MU<\/jats:styled-content>\n \/min) beam and minimized dose to the brainstem. Before each treatment, Winston\u2013Lutz quality assurance (\n QA<\/jats:styled-content>\n ) with submillimeter accuracy was performed. Clinical treatment response was evaluated using Barrow Neurological Institute (\n BNI<\/jats:styled-content>\n ) pain intensity score, rated from I to V.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Out of 27 patients, 22 (81%) and 5 (19%) suffered from\n typical<\/jats:italic>\n and\n atypical<\/jats:italic>\n TN<\/jats:styled-content>\n , respectively, and had median follow\u2010up interval of 12.5 months (ranged: 1\u201353 months). For 80 Gy prescriptions, delivered total average\n MU<\/jats:styled-content>\n was 19440 \u00b1 611. Average beam\u2010on\u2010time was 19.4 \u00b1 0.6 min. Maximum dose and dose to 0.5 cc of brainstem were 13.4 \u00b1 2.1 Gy (ranged: 8.4\u201315.9 Gy) and 3.6 \u00b1 0.4 Gy (ranged: 3.0\u20134.9 Gy), respectively. With a median follow\u2010up of 12.5 months (ranged: 1\u201345 months) in\n typical<\/jats:italic>\n TN<\/jats:styled-content>\n patients, the proportion of patients achieving overall pain relief was 82%, of which half achieved a complete pain relief with\n BNI<\/jats:styled-content>\n score of I\u2010\n II<\/jats:styled-content>\n and half demonstrated partial pain reduction with\n BNI<\/jats:styled-content>\n score of\n IIIA<\/jats:styled-content>\n \u2010\n IIIB<\/jats:styled-content>\n . Four\n typical<\/jats:italic>\n TN<\/jats:styled-content>\n patients (18%) had no response to radiosurgery treatment. Of the patients who responded to treatment, actuarial pain recurrence free survival rates were approximately 100%, 75%, and 50% at 12 months, 15 months, and 24 months, respectively. Five\n atypical<\/jats:italic>\n TN<\/jats:styled-content>\n patients were included, who did not respond to treatment (\n BNI<\/jats:styled-content>\n score:\n IV<\/jats:styled-content>\n \u2013V). However, no radiation\u2010induced cranial\u2010toxicity was observed in all patients treated.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Linac\u2010based\n SRS<\/jats:styled-content>\n for medically and\/or surgically refractory\n TN<\/jats:styled-content>\n is a fast, effective, and safe treatment option for patients with\n typical<\/jats:italic>\n TN<\/jats:styled-content>\n who had excellent response rates. Patients, who achieve response to treatment, often have durable response rates with moderate actuarial pain recurrence free survival. Longer follow\u2010up interval is anticipated to confirm our clinical observations.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.12057","type":"journal-article","created":{"date-parts":[[2017,3,16]],"date-time":"2017-03-16T12:14:06Z","timestamp":1489666446000},"page":"136-143","source":"Crossref","is-referenced-by-count":37,"title":["Linac\u2010based stereotactic radiosurgery (\n SRS<\/scp>\n ) in the treatment of refractory trigeminal neuralgia: Detailed description of\n SRS<\/scp>\n procedure and reported clinical outcomes"],"prefix":"10.1002","volume":"18","author":[{"given":"Damodar","family":"Pokhrel","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology The University of Kansas Cancer Center Kansas City KS USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Sood","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology The University of Kansas Cancer Center Kansas City KS 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