ИСТИНА

Purpose: To evaluate the effectiveness of using a Cyber-Knife for the treatment of patients with trigeminal neuralgia. To assess early and late complications of treatment. To define the indications and contraindications for stereotactic radiosurgery in this type of pathology. Material and methods: From January 2015 to March 2016, 31 patients with pharmaceutically-resistant trigeminal neuralgia received Cyber-Knife stereotactic radiosurgery (SRS). Medically therapy recived 100% patients and 55% patients recived others types of treatment before SRS. The prescription doses were the following: 9 patients got SRS in single dose of 70Gy; 9 patients got SRS in single dose of 76Gy; 14 patients got SRS in single dose of 80Gy. In all cases used a 5 mm-collimator and isocentric planning. Results: Median follow-up was 6.7 months (3-14); median age was 58 years (28-80). A complete response to treatment was obtained in 53%, partial pain relief in 25.1% and no effect in 21.9% of cases. There were no statistically significant dependence of response on the radiation dose in the range 70-80Gy. In 25.1% of cases there was a complication such as facial numbness. More than 60% of patients with zero effect of the treatment had some dysesthesia before SRS. Conclusions: Stereotactic radiosurgery can be used as an important method of treatment of trigeminal neuralgia. Possible predictor of zero effect of SRS maybe additional neurological deficit in innervation zone of trigeminal nerve. The treatment effectiveness is independent of dose in the range 70-80Gy. Prospective randomized trials are required to confirm this data.