Siempis Timoleon, Rehder Roberta, Voulgaris Spyridon, Alexiou George A
Department of Neurosurgery, University of Ioannina, Ioannina, Greece.
Division of Neurosurgery, HCor - Hospital do Coração, São Paulo, Brazil.
World Neurosurg X. 2024 Feb 25;22:100325. doi: 10.1016/j.wnsx.2024.100325. eCollection 2024 Apr.
Stereotactic radiosurgery (SRS) has recently gained space as an accepted non-invasive alternative treatment option for drug resistant Glossopharyngeal neuralgia (GPN). The purpose of this systematic review was to provide an overview of the outcomes of SRS treatment in patients with GPN.
A literature review until March 2023 was performed. Data about patient's demographics, complications and recurrence rates, additional treatment post procedure as well as pain outcomes in the short and long term were collected. Studies without reported pain outcomes were excluded.
Sixteen studies with a total of 97 patients diagnosed with GPN who had undergone SRS were identified. The mean reported maximal radiation dose ranged from 70 to 88.7 Gy with the glossopharyngeal meatus (GPM) being the most common target in 12/16 studies. The median time from SRS till pain response was between 2 and 120 days. The mean proportion of patients requiring further treatment after SRS ranged from 11.1 to 57.14% in a time frame between 2 and 36 months post procedure. Favourable pain response rates after SRS (BNI-IIIb) ranged from 60% to 100% and 57.1%-100% in short and long term respectively.
SRS for GPN remains a safe alternative to surgery with low complication rates and favourable pain outcomes in both short and long term.
立体定向放射外科（SRS）最近已成为药物难治性舌咽神经痛（GPN）公认的非侵入性替代治疗选择。本系统评价的目的是概述SRS治疗GPN患者的疗效。
进行了截至2023年3月的文献综述。收集了有关患者人口统计学、并发症和复发率、术后额外治疗以及短期和长期疼痛结局的数据。未报告疼痛结局的研究被排除。
确定了16项研究，共有97例诊断为GPN的患者接受了SRS治疗。报告的平均最大辐射剂量范围为70至88.7 Gy，舌咽道（GPM）是12/16项研究中最常见的靶点。从SRS到疼痛缓解的中位时间为2至120天。在术后2至36个月的时间范围内，SRS后需要进一步治疗的患者平均比例为11.1%至57.14%。SRS后（BNI-IIIb）的良好疼痛缓解率短期为60%至100%，长期为57.1%至100%。
SRS治疗GPN仍然是一种安全的手术替代方法，并发症发生率低，短期和长期疼痛结局良好。
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