A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors

Ivan, Michael E.; Sughrue, Michael E.; Clark, Aaron J.; Kane, Ari J.; Aranda, Derick; Barani, Igor J.; Parsa, Andrew T.

doi:10.3171/2010.9.jns10699

Cited by 115 publications

(123 citation statements)

References 66 publications

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“…Ivan and colleagues 15 conducted a meta-analysis in which they compared the morbidity of surgery and SRS. In that study, 869 patients were separated into 4 groups according to the treatment they had received: subtotal resection, gross-total resection, subtotal resection combined with SRS, or SRS alone.…”

Section: Discussionmentioning

confidence: 99%

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Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Gandía-González

Kusak

Moreno

et al. 2014

JNS

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Object Jugulotympanic paragangliomas (JTPs) are rare benign tumors whose surgical treatment is usually associated with partial resection of the lesion, high morbidity, and even death. Gamma Knife radiosurgery (GKRS) has been reported as a useful treatment option. The goal of this retrospective study is to analyze the role of GKRS in tumor volume control and clinical outcomes of these patients. Methods A total of 75 patients with JTPs were treated with GKRS at the authors' center from 1995 to 2012. The authors analyzed those treated during this period to allow for a minimal observation time of 2 years. The MR images and clinical reports of these patients were reviewed to assess clinical and volumetric outcomes of the tumors. The radiological and clinical assessments, along with a group of prognostic factors measured, were analyzed using descriptive methods. The time to volumetric and clinical progression was analyzed using the Kaplan-Meier method. Prognostic factors were identified using log-rank statistics and multivariate Cox regression models. Results The mean follow-up was 86.4 months. The authors observed volumetric tumor control in 94.8% of cases. In 67.2% of cases, tumor volume decreased by a mean of 40.1% from the original size. Of patients with previous tinnitus, 54% reported complete recovery. Improvement of other symptoms was observed in 34.5% of cases. Overall, clinical control was achieved in 91.4% of cases. Previous embolization and familial history of paraganglioma were selected as significant prognostic factors for volumetric response to GKRS treatment in the univariate analysis. In multivariate analysis, no factors were significantly correlated with progression-free survival. No patient died of side effects related to GKRS treatment or tumor progression. Conclusions Gamma Knife radiosurgery is an effective, safe, and efficient therapeutic option for the treatment of these tumors as a first-line treatment or in conjunction with traditional surgery, endovascular treatment, or conventional fractionated radiotherapy.

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Section: Discussionmentioning

confidence: 99%

“…2,28 However, this treatment has side effects. 23 Because of its efficacy and precision, Gamma Knife radiosurgery (GKRS) has been used successfully to treat JTPs in many centers, 4,5,[7][8][9]15,19,20,24,26,29 minimizing the radiation adverse effects.…”

mentioning

confidence: 99%

Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Gandía-González

Kusak

Moreno

et al. 2014

JNS

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“…34,48 Conventional fractionated radiation therapy doses of [45][46][47][48][49][50][51][52][53][54][55] Gy are commonly implemented, with relatively low incidences of postprocedural sequelae related to parenchymal radionecrosis, osteonecrosis of the temporal bone, mastoiditis, and mucositis. In general, individuals with SDHD mutations may be more amenable to SRS, given that these individuals are more likely to have multiple tumors and are at higher risk for recurrence.…”

Section: Stereotactic Radiosurgerymentioning

confidence: 99%

Molecular genetics of paragangliomas of the skull base and head and neck region: implications for medical and surgical management

Hussain¹,

Husain²,

Baredes

et al. 2014

JNS

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Paragangliomas are rare neuroendocrine tumors derived from neural crest cells of the autonomic nervous system. Tumors occurring in the thorax, abdomen, and pelvis are usually derived from sympathetic paraganglia, which are associated with catecholaminemia, headaches, and resistant hypertension. Pheochromocytomas, arising from chromaffin cells of the adrenal medulla, are histologically similar to sympathetic paragangliomas and can have identical clinical presentations. In contrast to these tumors, skull base and head and neck region paragangliomas (SHN-PGs) are usually derived from parasympathetic paraganglia and rarely secrete catecholamines. These tumors can present in a variety of locations, most commonly arising from glomus Type I (chief) cells of the carotid body. Less commonly they arise in regions of the temporal bone including the middle ear (glomus tympanicum) and jugular fossa (glomus jugulare) (Fig. 1A), as well as along the length of the vagus nerve (glomus vagale) and in the nose and paranasal sinuses (sinonasal paraganglioma). 60,69,75,77,93,99 These tumors Paragangliomas are rare, slow-growing tumors that frequently arise in the head and neck, with the carotid bodies and temporal bone of the skull base being the most common sites. These neoplasms are histologically similar to pheochromocytomas that form in the adrenal medulla and are divided into sympathetic and parasympathetic subtypes based on functionality. Skull base and head and neck region paragangliomas (SHN-PGs) are almost always derived from parasympathetic tissue and rarely secrete catecholamines. However, they can cause significant morbidity by mass effect on various cranial nerves and major blood vessels. While surgery for SHN-PG can be curative, postoperative deficits and recurrences make these lesions challenging to manage. Multiple familial syndromes predisposing individuals to development of paragangliomas have been identified, all involving mutations in the succinate dehydrogenase complex of mitochondria. Mutations in this enzyme lead to a state of "pseudohypoxia" that upregulates various angiogenic, survival, and proliferation factors. Moreover, familial paraganglioma syndromes are among the rare inherited diseases in which genomic imprinting occurs. Recent advances in gene arrays and transcriptome/exome sequencing have identified an alternate mutation in sporadic SHN-PG, which regulates proto-oncogenic pathways independent of pseudohypoxia-induced factors. Collectively these findings demonstrate that paragangliomas of the skull base and head and neck region have a distinct genetic signature from sympathetic-based paragangliomas occurring below the neck, such as pheochromocytomas. Paragangliomas serve as a unique model of primarily surgically treated neoplasms whose future will be altered by the elucidation of their genomic complexities. In this review, the authors present an analysis of the molecular genetics of SHN-PG and provide future directions in patient care and the development of novel therapies. 321Abbreviations used in ...

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“…A recent comprehensive review identified 109 studies for a total of 869 patients described outcomes for patients with glomus jugulare tumours [72]. Patients undergoing SRS had the lowest rates of recurrence and the most favourable rates of tumour control.…”

Section: • Pituitary Adenomamentioning

confidence: 99%

Radiosurgery and Hypofractionated Stereotactic Irradiation with Photons or Protons for Tumours of the Skull Base

Amelio¹,

Cianchetti²,

Rombi³

et al. 2013

Cancer Treatment - Conventional and Innovative Approaches

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A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors

Cited by 115 publications

References 66 publications

Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Jugulotympanic paragangliomas treated with Gamma Knife radiosurgery: a single-center review of 58 cases

Molecular genetics of paragangliomas of the skull base and head and neck region: implications for medical and surgical management

Radiosurgery and Hypofractionated Stereotactic Irradiation with Photons or Protons for Tumours of the Skull Base

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