Outcome After Pituitary Radiosurgery for Thalamic Pain Syndrome

Motohiro Hayashi, Mikhail F. Chernov, Takaomi Taira, Taku Ochiai, Kotaro Nakaya, Noriko Tamura, Shinichi Goto, Shoji Yomo, Nobuo Kouyama, Yoko Katayama, Yoriko Kawakami, Masahiro Izawa, Yoshihiro Muragaki, Ryoichi Nakamura, Hiroshi Iseki, Tomokatsu Hori, Kintomo Takakura

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To evaluate outcomes after pituitary radiosurgery in patients with post-stroke thalamic pain syndrome. Methods and Materials: 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). Results: 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. Conclusions: 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.

Original languageEnglish
Pages (from-to)852-857
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume69
Issue number3
DOIs
Publication statusPublished - 2007 Nov 1
Externally publishedYes

Fingerprint

Thalamic Diseases
pain
Radiosurgery
Pain
Pituitary Gland
strokes
therapy
pituitary gland
Therapeutics
Stroke
Diabetes Insipidus
Hypesthesia
Tokyo
Hyponatremia
abnormalities
deterioration
examination

Keywords

  • Gamma Knife radiosurgery
  • Outcome
  • Pituitary irradiation
  • Thalamic pain syndrome
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Hayashi, M., Chernov, M. F., Taira, T., Ochiai, T., Nakaya, K., Tamura, N., ... Takakura, K. (2007). Outcome After Pituitary Radiosurgery for Thalamic Pain Syndrome. International Journal of Radiation Oncology Biology Physics, 69(3), 852-857. https://doi.org/10.1016/j.ijrobp.2007.04.043

Outcome After Pituitary Radiosurgery for Thalamic Pain Syndrome. / Hayashi, Motohiro; Chernov, Mikhail F.; 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.

In: International Journal of Radiation Oncology Biology Physics, Vol. 69, No. 3, 01.11.2007, p. 852-857.

Research output: Contribution to journalArticle

Hayashi, M, Chernov, MF, Taira, T, Ochiai, T, Nakaya, K, Tamura, N, Goto, S, Yomo, S, Kouyama, N, Katayama, Y, Kawakami, Y, Izawa, M, Muragaki, Y, Nakamura, R, Iseki, H, Hori, T & Takakura, K 2007, 'Outcome After Pituitary Radiosurgery for Thalamic Pain Syndrome', International Journal of Radiation Oncology Biology Physics, vol. 69, no. 3, pp. 852-857. https://doi.org/10.1016/j.ijrobp.2007.04.043
Hayashi, Motohiro ; Chernov, Mikhail F. ; 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. / Outcome After Pituitary Radiosurgery for Thalamic Pain Syndrome. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 69, No. 3. pp. 852-857.
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abstract = "Purpose: To evaluate outcomes after pituitary radiosurgery in patients with post-stroke thalamic pain syndrome. Methods and Materials: 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). Results: 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. Conclusions: 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.",
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AU - Chernov, Mikhail F.

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AU - Nakaya, Kotaro

AU - Tamura, Noriko

AU - Goto, Shinichi

AU - Yomo, Shoji

AU - Kouyama, Nobuo

AU - Katayama, Yoko

AU - Kawakami, Yoriko

AU - Izawa, Masahiro

AU - Muragaki, Yoshihiro

AU - Nakamura, Ryoichi

AU - Iseki, Hiroshi

AU - Hori, Tomokatsu

AU - Takakura, Kintomo

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N2 - Purpose: To evaluate outcomes after pituitary radiosurgery in patients with post-stroke thalamic pain syndrome. Methods and Materials: 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). Results: 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. Conclusions: 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.

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