Comparative Neurologic Outcomes of Salvage and Definitive Gamma Knife Radiosurgery for Glomus Jugulare: A 20-Year Experience

Abstract

This case series investigates management of glomus jugulare (GJ) tumors utilizing definitive and salvage Gamma Knife stereotactic radiosurgery (GKSRS). A retrospective chart review was performed to collect data. Statistical analysis included patient, tumor, and treatment information. From 1996 to 2013, 17 patients with GJ received GKSRS. Median age was 64 years (range, 27-76). GKSRS was delivered for definitive treatment in eight (47%) and salvage in nine (53%) patients. Median tumor volume was 9.8 cm (range, 2.8-42 cm ). Median dose was 15 Gy (range, 13-18 Gy). Median follow-up was 123 months (range, 38-238 months). Tumor size decreased in 10 (59%), stabilized in 6 (35%), and increased in 1 patient (6%). Overall neurological deficit improved in 53%, stabilized in 41%, and worsened in 6% of patients. Overall cause-specific survival was 100%, and actuarial local control was 94%. Eighty-eight percent of patients without prior resection experienced neurologic deficit improvement, while 25% of patients with prior resection experienced neurologic improvement ( = 0.02). Gamma Knife radiosurgery provides effective long-term control of GJ and overall improvement or stabilization of neurological deficit in most patients. Patients with prior resection are less likely to experience improvement of neurologic deficit.

Long-Term Results of Gamma Knife Radiosurgery for Glomus Tumors: An Analysis of 32 Patients

“…This study adds to the body of literature supporting the use of GKRS alone as an upfront definitive management of GJTs [1][2]. This analysis confirms that GKRS effectively treats GJTs with excellent long-term tumor control.…”

“…Also, only one patient endured a recurrence five years after surgery. This study had no operative complications or mortality [2].…”

“…A comparable paper, Wakefield et al [2], collected data from 17 patients who received GKRS for GJTs. There was a nearly equal distribution of males and females (seven males, 10 females), with a median age of 64 years.…”

“…Glomus jugulare tumors (GJTs) are rare slow-growing hypervascular benign tumors that arise from the paraganglia of the chemoreceptor system within the jugulare foramen of the temporal lobe [1]. These are the most common tumors of the middle ear and occur predominantly in women, with three to six women for every man diagnosed [2,3]. Common symptoms include hearing loss, pulsatile tinnitus, and lower cranial nerve (CN) deficits [1].…”

The long-term outcome of CyberKnife therapy for head and neck paraganglioma: Management suggestion from a single center experience

“…Although quite a few case series demonstrating the effects of gamma knife treatment to HNPGs exist [14,20,8,19], CKT evidence for these tumors still need to be accumulated especially long-term results [1]. We believe that our series of 29 cases, although the number of cases are not as many as some previous studies, the relatively longer median follow-up period of 66 months (15 cases were followed for more than ve years) adds further valuable data to the current literature.…”