Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025
Unraveling the role of pituitary radiosurgery in the management of chronic pain.
СтатьяМетаанализСистематический обзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Azab Mohammed A, Sarhan Khalid, Shama Mohsen Nabih, Clervius Helene
Аннотация
BACKGROUND: Several decades ago, cancer pain was treated with surgical and chemical adenolysis, and it was associated with several complications. Therefore, radiosurgery of the pituitary was reevaluated again for the potential use in managing medication refractory chronic pain.
METHODS: A systematic review was conducted according to PRISMA guidelines using the PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases to identify the studies that described pituitary stereotactic radiosurgery for the management of refractory pain. A meta-analysis was performed on relevant variables.
RESULTS: We included 14 studies in the analysis. About 114 patients were treated for chronic pain with pituitary radiosurgery. About 47 patients were identified with thalamic or poststroke pain and 67 patients with cancer related pain. Different parts of the pituitary were targeted, and the prescription dose ranged from 140 to 250 Gy. The maximum dose exposure to the optic nerve was below 10 Gy. The mean time for the first pain response following intervention was 5.94 days. The proportion of patients who demonstrated a response to stereotactic radiosurgery in terms of pain improvement was 98.2 %. No visual complications were reported over a one-year follow-up. Endocrinal complications after one year were about 2 %.
CONCLUSION: This systematic review provides evidence on the safety and effectiveness of radiosurgery in the management of chronic medication refractory pain. Gamma knife radiosurgery of the pituitary gland could be a promising option for the management of intractable chronic pain caused by cancer or complicated cerebrovascular accidents.
METHODS: A systematic review was conducted according to PRISMA guidelines using the PubMed, Scopus, Web of Science, Embase, and Cochrane Library databases to identify the studies that described pituitary stereotactic radiosurgery for the management of refractory pain. A meta-analysis was performed on relevant variables.
RESULTS: We included 14 studies in the analysis. About 114 patients were treated for chronic pain with pituitary radiosurgery. About 47 patients were identified with thalamic or poststroke pain and 67 patients with cancer related pain. Different parts of the pituitary were targeted, and the prescription dose ranged from 140 to 250 Gy. The maximum dose exposure to the optic nerve was below 10 Gy. The mean time for the first pain response following intervention was 5.94 days. The proportion of patients who demonstrated a response to stereotactic radiosurgery in terms of pain improvement was 98.2 %. No visual complications were reported over a one-year follow-up. Endocrinal complications after one year were about 2 %.
CONCLUSION: This systematic review provides evidence on the safety and effectiveness of radiosurgery in the management of chronic medication refractory pain. Gamma knife radiosurgery of the pituitary gland could be a promising option for the management of intractable chronic pain caused by cancer or complicated cerebrovascular accidents.