Radiation Oncology Journal

  • 제24권2호
  • /
  • Pages.88-95
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  • 2006
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  • 2234-1900(pISSN)
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  • 2234-3156(eISSN)
대한방사선종양학회 (The Korean Society for Radiation Oncology)
권호 표지

삼차신경통에 대한 사이버나이프 방사선수술의 조기 치료 효과

Early Therapeutic Effects of Cyberknife Radiosurgery on Trigeminal Neuralgia

  • 문성권 (가톨릭대학교 의과대학 방사선종양학교실) ;
  • 최일봉 (가톨릭대학교 의과대학 방사선종양학교실) ;
  • 강영남 (가톨릭대학교 의과대학 방사선종양학교실) ;
  • 장지선 (가톨릭대학교 의과대학 방사선종양학교실) ;
  • 강기문 (경상대학교 의과대학 방사선종양학교실) ;
  • 최병옥 (가톨릭대학교 의과대학 방사선종양학교실)
  • Mun Seong-Kwon (Department of Radiation Oncology, The Catholic University of Korea College of Medicine) ;
  • Choi Ihl-Bohng (Department of Radiation Oncology, The Catholic University of Korea College of Medicine) ;
  • Kang Young-Nam (Department of Radiation Oncology, The Catholic University of Korea College of Medicine) ;
  • Jang Ji-Sun (Department of Radiation Oncology, The Catholic University of Korea College of Medicine) ;
  • Kang Ki-Mun (Gyeongsang National University School of Medicine) ;
  • Choi Byung-Ock (Department of Radiation Oncology, The Catholic University of Korea College of Medicine)
  • 발행 : 2006.06.01
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초록

목적: 삼차신경통 환자에서 사이버나이프 방사선수술이 효과적이며 안전한 치료방법인지 알아보고자 하였다. 대상 및 방법: 2004년 3월부터 2005년 5월까지 수술 후 실패하였거나 수술이 부적합한 삼차신경통 환자 26명을 대상으로 사이버나이프 방사선수술을 시행하여 후향적 분석을 하였다. 치료 표적은 삼차신경근 진입구역으로부터 3 mm 떨어진 지점의 삼차신경 최고 근위부를 제외한 6 mm 길이의 삼차신경 부위를 설정하고, 그 부위에 80% 등선량 곡선에 단일 조사로 총방사선량은 $60{\sim}64Gy$를 조사하였다(중앙선량: 64 Gy). 결과: 추적관찰기간은 $3{\sim}15$개월이었다(중앙추적관찰기간 : 9개월). 대상환자 26명에서 사이버나이프 방사선수술 후 24시간 이내에 50% (13/26)에서 통증 완화를 관찰하였으며. 7일 이내에 조기 통증 완화를 보였던 환자는 96.2% (25/26)이었다. 치료 실패는 7.7% (2/26)에서 나타났으며 통증 개선 실패와 통증 재발이 각각 1명에서 관찰되었다. 치료 부작용으로 안면감각 감퇴가 11.5% (3/26)에서 관찰되었다. 결론: 삼차신경통 환자를 대상으로 사이버나이프 방사선수술을 시행한 예비 결과로 비교적 안전하며, 효과적인 치료임을 확인하였다.

Purpose: We evaluated whether Cyberknife radiosurgery is an effective and safe method of therapy for medically intractable trigeminal neuralgia (TN). Materials and Methods: We retrospectively analyzed the outcome of 26 patients, who failed to surgery or were not suitable candidates for invasive intervention and were treated by Cyberknife radiosurgery between March 2004 and May 2005. Radiosurgery doses of $60{\sim}64 Gy$ were delivered to the 80% isodose line prescribed to an 6 mm length of the nerve, sparing the most proximal 3 mm away from the trigeminal nerve root entry zone (median dose: 64 Gy). Results: Follow-up period was $3{\sim}15$ months (median follow-up period: 9 months) Preliminary results from a cohort of 26 patients undergoing Cyberknife radiosurgery for TN showed that pain relief was achieved in 50% (13/26) of patients within the first 24 hrs after treatment. At last follow-up, 96.2% (25/26) of patients reported early pain relief within 7 days. Treatment failure developed in 2 of 26. Poor response occurred in one patient and relapse was observed in the other patient. 3 patients had hypoesthesia (11.5%), which was the only complication observed with any of our patients. Conclusion: With these results, authors assumed that Cyberknife radiosurgery for TN could be one of safe and effective therapeutic methods.

키워드

참고문헌

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