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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.

Stieber V, Robbins M, Balamucki C, deGuzman A, Tatter S, Ekstrand K, McMullen K, Branch C, Shaw E, Bourland JD, Lovato J, Munley M, Ellis T

Radiation Oncology, Wake Forest University School of Medicine, Winston-Salem, NC 27157-1030, USA. vstieber@wfubmc.edu

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 T(1/2), resulting in a range of 1.28-1.77 h for T(1/2). 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.

Published 19 July 2007 in Radiat Res, 168(2): 143-8.
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