Use of High Definition Multileaf Colimator for the Treatment of Trigeminal Neuralgia

Abstract

In the present work, a treatment technique for trigeminal neuralgia (TN) using LINAC radiosurgery is shown. The technique is based on the optimization of ten static arcs in such a way as to minimize the overlapping of the treatment fields with the brainstem. We will call this technique brainstem-optimized (BO). The results are compared with another technique described in the literature known as a virtual cone (VC). The comparison of dosimetry results that have been carried out essentially shows that the doses in the brainstem V12Gy-brainstem, D0.5cm3-brainstem and D0.035 cm3-brainstem are lower in the BO versus VC technique, and with the parameters V50% (whole brain) and V12Gy-cerebrum higher in BO versus VC. Our goal is to keep the dose to the brainstem as low as possible and, if possible, at most between 12 Gy and 15 Gy. The BO technique meets our purposes and is considered clinically acceptable at our institution.