{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T15:56:53Z","timestamp":1792079813945,"version":"4.4.0"},"reference-count":19,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"Special_Supplement","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The object of this study was to determine whether the radiation dose rate affects clinical outcomes in patients who undergo stereotactic Gamma Knife surgery (GKS) to manage typical trigeminal neuralgia (TN).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The authors retrospectively studied pain relief in 165 patients with medically intractable TN, who underwent 80-Gy GKS using a single 4-mm collimator between 1994 and 2005. No patient had received prior radiation treatment. The measured relative helmet output factor of the Gamma Knife was 0.8 throughout this interval, and the dose rate varied from 1.21 Gy\/minute to 3.74 Gy\/minute (median 2.06 Gy\/minute). Irradiation time varied from 26.73 to 95.11 minutes. The authors divided patients into a low-dose-rate (LDR) group, in which the dose rate varied from 1.21 to 2.05 Gy\/minute, and a high-dose-rate (HDR) group, in which the dose rate varied from 2.06 to 3.74 Gy\/minute. Post-GKS, the patients' pain control was determined using the Barrow Neurological Institute (BNI) pain scale.<\/jats:p>\n<jats:p>There was no statistically significant difference between groups with respect to history of prior microvascular decompression (p = 0.410) or peripheral neuroablative procedures (p = 0.583). The length of symptoms in patients varied from 3 to 414 months with a median of 84 months (p = 0.698). Median follow-up was 26 months with a maximum of 139 months.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Initial pain relief was obtained in 71% of patients in the LDR group and 78% in the HDR group (p = 0.547). Patients who initially obtained improved pain relief (BNI Scores I\u2013IIIa) after GKS maintained pain control for median durations of 52 months (LDR group) and 54 months (HDR group) (p = 0.403). New or increased facial sensory dysfunction was found in 14.5% of patients in the LDR group and in 19.3% of patients in the HDR group (p = 0.479).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>The authors found that the GKS dose rate did not affect pain control or morbidity within the range of 1.21\u20133.74 Gy\/minute. Cobalt 60 source decay did not affect outcomes of GKS for TN pain management, even for dose rates approximating a 2-half-life decay of the isotope.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.7.gks101049","type":"journal-article","created":{"date-parts":[[2018,11,16]],"date-time":"2018-11-16T01:09:47Z","timestamp":1542330587000},"page":"168-171","source":"Crossref","is-referenced-by-count":27,"title":["Does the Gamma Knife dose rate affect outcomes in radiosurgery for trigeminal neuralgia?"],"prefix":"10.3171","volume":"113","author":[{"given":"Yoshio","family":"Arai","sequence":"first","affiliation":[{"name":"Radiation Oncology, and the Center for Image-Guided Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideyuki","family":"Kano","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Dade","family":"Lunsford","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Novotny","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and the Center for Image-Guided Neurosurgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Niranjan","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C.","family":"Flickinger","sequence":"additional","affiliation":[{"name":"Radiation Oncology, and the Center for Image-Guided Neurosurgery,"},{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Kondziolka","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery and"},{"name":"University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1130168","series-title":"J Neurosurg","first-page":"730","article-title":"Does dose rate affect efficacy? The outcomes of 256 gamma knife surgery procedures for trigeminal neuralgia and other types of facial pain as they relate to the half-life of cobalt","volume":"105","author":"Balamucki","year":"2006"},{"key":"b2-1130168","series-title":"Int J Radiat Oncol Biol Phys","first-page":"181","article-title":"Conditions for the equivalence of continuous to pulsed low dose rate brachytherapy","volume":"20","author":"Brenner","year":"1991"},{"key":"b3-1130168","series-title":"Mutat Res","first-page":"61","article-title":"Plasma membrane signaling induced by ionizing radiation","volume":"704","author":"Corre","year":"2010"},{"key":"b4-1130168","series-title":"Int J Radiat Oncol Biol Phys","first-page":"449","article-title":"Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? A prospective double-blind, randomized study","volume":"51","author":"Flickinger","year":"2001"},{"key":"b5-1130168","series-title":"Neurosurgery","first-page":"971","article-title":"Histological effects of trigeminal nerve radiosurgery in a primate model: implications for trigeminal neuralgia radiosurgery","volume":"46","author":"Kondziolka","year":"2000"},{"key":"b6-1130168","series-title":"J Neurosurg","first-page":"940","article-title":"Stereotactic radiosurgery for trigeminal neuralgia: a multiinstitutional study using the gamma unit","volume":"84","author":"Kondziolka","year":"1996"},{"key":"b7-1130168","series-title":"J Neurosurg","first-page":"758","article-title":"Gamma Knife stereotactic radiosurgery for idiopathic trigeminal neuralgia. 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