TRIGEMINAL NEURALGIA TREATED USING TRILOGY TECHNOLOGY.
"Trigeminal neuralgia is a very incapacitating pain disorder," said Kevin Murphy, M.D., chief of the stereotactic radiosurgery program in the Department of Radiation Oncology at UCSD Medical Center. "By the time she came to us for evaluation, Mrs. Taylor was at the end of her rope. She had tried many different treatments, including drug therapies, radiosurgery with cobalt sources, and, most recently, balloon compression of the left trigeminal nerve. She gained relief for a period of months, but her severe pain always returned."
In February of this year, Taylor's neurosurgeon John Alksne, MD, asked Murphy to evaluate her for possible treatment on the Trilogy machine, a powerful medical linear accelerator that delivers precisely targeted and finely shaped beams of radiation to destroy tumors or other abnormalities. Alksne's hope was to eradicate or at least ameliorate Taylor's unbearable pain once and for all.
"The trigeminal nerve is responsible for sensation in the jaw and face, so you don't want to destroy it, but you have to calm it down and stop it from firing randomly," explained Alksne, who is a professor of neurosurgery at UCSD. Trilogy treatments are a painless, noninvasive, and typically performed on an outpatient basis in less than an hour. Using computed tomography (CT) and magnetic resonance (MR) images of the area to be treated, Murphy worked with his clinical team to design a treatment plan for Taylor that would focus the radiosurgery beams on her trigeminal nerve while protecting her eyes, optic nerves, and brainstem.
The Trilogy machine is outfitted with two imaging systems that make it possible to deliver radiation with great precision: the On-Board Imager(R) device for generating 3-D images of the targeted area prior to treatment, and the FramelessArray(TM) optical guidance system, which uses an optical camera to continuously monitor the patient's position during treatment.
"Eleanor had been through a cobalt radiosurgical procedure, which requires immobilization with a fixation device that is screwed into the skull, and she did not want to repeat that experience," Alksne explained. "She was very pleased when we told her that treatment on Varian's Trilogy machine would not require this kind of bolted headframe immobilization. With the Trilogy machine, the image guidance tools help us to ensure that treatment beams are delivered accurately."
To perform the radiosurgery, Murphy and Alksne used a tiny beam 5 millimeters in diameter. The procedure was complete after just 40 minutes. "We anticipated that it would take anywhere from two weeks to two months for us to know how much benefit Eleanor was going to realize from the treatment," Alksne said. By the end of two months, Eleanor's pain had completely disappeared, and the result has been durable.
"I'm doing fine," she said in a recent phone interview. "I've been driving into the city and I'm glad to have that freedom back because I'm a very independent person. I haven't had any more pain."
Taylor was introduced to Dr. Alksne through a trigeminal neuralgia support group in San Diego that provided her with information about the condition and its treatment.
"I want people to know about this disease, and to know about support groups, because they are a life saver. I worry about people who have this kind of pain and don't know where to go. They need to find a support group and a neurosurgeon like Dr. Alksne. He has done everything possible to help me," she said.
About UCSD Health Sciences
The University of California, San Diego (UCSD) Health Sciences encompasses the School of Medicine, the Skaggs School of Pharmacy and Pharmaceutical Sciences, and UCSD Medical Center -- the system of patient services provided at the UCSD Medical Center, Hillcrest; UCSD Thornton Hospital, La Jolla; the Moores UCSD Cancer Center; and other centers, primary and specialty practices of the UCSD Medical Group faculty physicians. As a top-tier academic medical center, its role is to provide leadership in improving health through research, education and patient care.
For more information, call 619/543-6427.
About Varian Medical Systems
Varian Medical Systems, Inc., of Palo Alto, California, is the world's leading manufacturer of medical devices and software for treating cancer and other medical conditions with radiotherapy, radiosurgery, proton therapy, and brachytherapy. The company supplies informatics software for managing comprehensive cancer clinics, radiotherapy centers and medical oncology practices. Varian is a premier supplier of tubes and digital detectors for X-ray imaging in medical, scientific, and industrial applications and also supplies X-ray imaging products for cargo screening and industrial inspection. Varian Medical Systems employs approximately 4,300 people who are located at manufacturing sites in North America and Europe and in its 56 sales and support offices around the world.
For more information, visit http://www.varian.com or call 650/424-6444.
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|Publication:||Biotech Equipment Update|
|Date:||Aug 1, 2007|
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