Shan Guo-Yong, Liang Hao-Fang, Zhang Jian-Hua
The Radiotherapy Department of Zhengzhou People's Hospital, Zhengzhou 450052, Henan Province, China.
Int J Ophthalmol. 2011;4(2):121-4. doi: 10.3980/j.issn.2222-3959.2011.02.02. Epub 2011 Apr 18.
To probe into problems existing in gamma knife treatment of ophthalmic branch of primary trigeminal neuralgia (TN), and propose a safe and effective solution to the problem.
Through sorting the literature reporting gamma knife treatment of refractory TN in recent years, this article analyzed the advantages and problems of gamma knife treatment of primary TN, and proposed reasonable assessment for existing problems and the possible solution.
Gamma knife treatment of TN has drawn increasing attention of clinicians due to its unique non-invasion, safety and effectiveness, but there are three related issues to be considered. The first one is the uncertainty of the optimal dose (70-90GY); the second one is the difference in radiotherapy target selection (using a single isocenter or two isocenters); and the third one is the big difference of recurrent pains (specific treatment methods need to be summarized and improved).
For patients with refractory TN, gamma knife treatment can be selected when the medical treatment fails or drug side effects emerge. The analysis of a large number of TN patients receiving gamma knife treatment has shown that this is a safe and effective treatment method.
探讨原发性三叉神经痛（TN）眼支伽玛刀治疗中存在的问题，并提出安全有效的解决方案。
通过整理近年来报道伽玛刀治疗难治性TN的文献，分析伽玛刀治疗原发性TN的优势及问题，并对存在的问题提出合理评估及可能的解决办法。
伽玛刀治疗TN因其独特的无创性、安全性和有效性而越来越受到临床医生的关注，但有三个相关问题需要考虑。第一个是最佳剂量（70 - 90GY）的不确定性；第二个是放射治疗靶点选择的差异（使用单个等中心或两个等中心）；第三个是复发疼痛差异较大（需要总结和改进具体治疗方法）。
对于难治性TN患者，当药物治疗无效或出现药物副作用时可选择伽玛刀治疗。对大量接受伽玛刀治疗的TN患者的分析表明，这是一种安全有效的治疗方法。
