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Stereotactic Radiosurgery for Tumor-Related Trigeminal Neuralgia: A Systematic Review and Meta-Analysis Publisher Pubmed



Hajikarimloo B1 ; Mohammadzadeh I2 ; Tos SM3 ; Hasanzade A1 ; Sahrai H4 ; Taghipour P5 ; Amjadzadeh M6 ; Najari D1 ; Ebrahimi A1 ; Roustaei E7 ; Habibi MA8
Authors
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Authors Affiliations
  1. 1. Department of Neurosurgery, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  2. 2. Skull Base Research Center, Loghman-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neurological Surgery, University of Virginia, Charlottesville, VA, United States
  4. 4. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
  5. 5. Private Mersin Sistem Surgical Medical Center, Turkiye, Mersin, Turkey
  6. 6. Department of Radiology, University of Pittsburgh Medical Center, PA, United States
  7. 7. Student Research Committee, School of Medicine, Iran University of Medical Science, Tehran, Iran
  8. 8. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: BMC Neurology Published:2025


Abstract

Background: Tumor-related trigeminal neuralgia (TRTN) accounts for approximately 6% of all facial pain syndromes. Conventional medical treatments have short-term pain relief effects in TRTN cases; however, they are correlated with substantial failure rates of 63–100%. Microsurgical resection (MS) and stereotactic radiosurgery (SRS) are the two primary therapeutic options for the management of TRTNs. This systematic review and meta-analysis evaluated the pain-related outcomes and complications of SRS in TRTNs. Methods: A systematic literature search was conducted on February 24, 2025, comparing PubMed, Embase, Scopus, and Web of Science. Studies reporting pain-related outcomes and adverse radiation effects (ARE) for SRS in TRTNs were included. Results: Nineteen studies with 454 patients were included. Meningioma (67.7%, 304/449) was the most common tumor, followed by vestibular schwannoma (VS) (18.3%, 82/449) and trigeminal schwannoma (8.2%, 37/449). Our meta-analysis demonstrated that SRS is associated with a pooled complete pain-free rate of 38% (95% CI: 27-50%), an adequate pain relief rate of 73% (95% CI: 63-83%), and an ARE rate of 14% (95% CI: 7-22%). In those where the underlying etiology was pertoclival meningiomas, SRS resulted in a pooled complete pain-free rate of 30% (95%CI: 5-64%), an adequate complete pain relief rate of 64% (95%CI: 33-90%), and an ARE rate of 13% (95%CI: 0-48%). Conclusion: SRS is associated with favorable pain-related outcomes and low ARE rates in patients with TRTN. Both tumor-only related and dual-targeted approaches are associated with comparable outcomes. © The Author(s) 2025.
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