HAYASHI Motohiro
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor
Article types Case report
Language English
Peer review Peer reviewed
Title Outcome after pituitary radiosurgery for thalamic pain syndrome
Journal Formal name:Int J Radiat Oncol Biol Phys
ISSN code:03603016
Volume, Issue, Page 69(3),pp.852-857
Author and coauthor HAYASHI Motohiro†, CHERNOV Mikhail, TAIRA Takaomi, OCHIAI Taku, NAKAYA Kotaro, TAMURA Noriko, GOTO Shinichi, YOMO Shoji, KOUYAMA Nobuo, KATAYAMA Yoko, KAWAKAMI Yoriko, IZAWA Masahiro, MURAGAKI Yoshihiro†, NAKAMURA Ryoichi, ISEKI Hiroshi, HORI Tomokatsu, TAKAKURA Kintomo
Authorship Lead author
Publication date 2007/11
Summary To evaluate outcomes after pituitary radiosurgery in patients with post-stroke thalamic pain syndrome.|From 2002 to 2006, 24 patients with thalamic pain syndrome underwent pituitary radiosurgery at Tokyo Women's Medical University and were followed at least 12 months thereafter. The radiosurgical target was defined as the pituitary gland and its connection with the pituitary stalk. The maximum dose varied from 140 to 180 Gy. Mean follow-up after treatment was 35 months (range, 12-48 months).|Initial pain reduction, usually within 48 h after radiosurgery, was marked in 17 patients (71%). However, in the majority of cases the pain recurred within 6 months after treatment, and at the time of the last follow-up examination durable pain control was marked in only 5 patients (21%). Ten patients (42%) had treatment-associated side effects. Anterior pituitary abnormalities were marked in 8 cases and required hormonal replacement therapy in 3; transient diabetes insipidus was observed in 2 cases, transient hyponatremia in 1, and clinical deterioration due to increase of the numbness severity despite significant reduction of pain was seen once.|Pituitary radiosurgery for thalamic pain results in a high rate of initial efficacy and is accompanied by acceptable morbidity. It can be used as a primary minimally invasive management option for patients with post-stroke thalamic pain resistant to medical therapy. However, in the majority of cases pain recurrence occurs within 1 year after treatment.
DOI 10.1016/j.ijrobp.2007.04.043
Document No. 17570607