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Purpose: Gamma Knife radiosurgery (GKRS) is used in the treatment of trigeminal neuralgia (TN) to deliver precise, focused ionizing radiation to the trigeminal nerve, thereby reducing its ability to transmit pain signals. Understanding the impact of unique radiobiological parameters, such as the biologically effective dose (BED) and dose rate, in GKRS is essential to optimize treatment protocols and ensure predictable therapeutic outcomes. We conducted a systematic review and meta-analysis to evaluate how BED and dose rate impact GKRS effectiveness and toxicity. Methods and Materials: We searched medical and health care databases from inception to May 19, 2024, for publications reporting on the impact of GKRS BED and/or dose rate on TN outcomes. Following 2 rounds of screening conducted in duplicate, we used random-effects meta-analysis and meta-regression to examine the association between dose rate and pain relief. Results: = .71). Conclusions: Higher dose rates in GKRS may be associated with better pain relief in TN. Dose rate should be considered in the treatment of TN when using GKRS.
Jomy et al. (Sat,) studied this question.