Radiation Research

Published by: Radiation Research Society

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Radiation Research 168(2):143-148. 2007
doi: 10.1667/RR0620.1

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

Volker Stieber1a, Michael Robbinsa, Christopher Balamuckib, Allan deGuzmana, Stephen Tatterc, Kenneth Ekstranda, Kevin McMullena, Charles Branchb, Edward Shawa, J. Daniel Bourlanda, James Lovatod, Michael Munleya, and Thomas Ellisc

aRadiation Oncology, Wake Forest University School of Medicine, Winston-Salem, North Carolina;

bWake Forest University School of Medicine, Winston-Salem, North Carolina;

cNeurosurgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina;

dPublic Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina

1Address for correspondence: Department of Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1030;

Abstract

Stieber, V. W., Robbins, M., Balamucki, C., DeGuzman, A., Tatter, S. B., Ekstrand, K. E., McMullen, K. P., Branch, C., Shaw, E. G., Bourland, J. D., Lovato, J., Munley, M. T. and Ellis, T. L. 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. Radiat. Res. 168, 143–148 (2007).

Stereotactic radiosurgery (GKRS) using the Leksell Gamma Knife is a treatment option for patients with trigeminal pain. We analyzed a database of 326 GKRS procedures performed over 4.6 years at three discrete dose levels commonly described in the published literature. Logistic regression was used to model the logit of response as a function of treatment time. The resulting coefficient was converted to an estimated probability of response for the shortest and longest treatment times in clinical practice. The two estimated probabilities were then compared to yield the estimated difference in the biologically effective dose (BED) between the two doses, using a modified linear-quadratic model for stereotactic radiosurgery. This difference was used to back-calculate a clinical value for T1/2, resulting in a range of 1.28–1.77 h for T1/2. The biological model appeared to accurately predict that, given the doses and treatment times used in general clinical practice, there would be no significant difference in clinical outcome.

Received: March 14, 2006; Accepted: March 15, 2007



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FIG. 1. Facial pain control after Gamma Knife radiosurgery and subsequent recurrence rates

FIG. 2. Relationship of BED to dose rate for the three most commonly used prescription doses. () 80 Gy, (█) 85 Gy, (—) 90 Gy

table

TABLE 1 Pairwise Comparison of BED Dependent on t for Given T½ and α/β

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TABLE 2 Facial Pain Control Rates

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TABLE 3 Time to Pain Relief and Length of Pain-Free Interval

 
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