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
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.