Glomus jugulare tumors long-term control by radiation therapy

Lamer, James M.; Hahn, Seung S.; Spaulding, Cynthia A.; Constable, William C.

doi:10.1002/1097-0142(19920401)69:7<1813::aid-cncr2820690725>3.0.co;2-p

Cited by 85 publications

(52 citation statements)

References 24 publications

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“…Others view radiotherapy as the initial treatment 5,9,11 due to the morbidity of surgical procedure. The objective is to have local/regional control of the disease in the long term, without any subjective our objective progression of the disease.…”

Section: Discussioncontrasting

confidence: 89%

“…The stroma showed itself as more reactive to radiotherapy and was replaced by fibrous tissue rich in fibroblasts, similarly to vascularization in which one may observe changes such as perivascular fibrosis, endothelial hyperplasia and subendothelial degeneration. In the presented series it was possible to find 2:1 ratio favorable to women, which is somewhat different from the literature that sets a ratio of 4 to 7:1 4,9 .The age range of onset of tumors was 43 to 87 years (mean 62.4 years) a little higher then reported in literature, with higher incidence of tumors occurring between 5th and 6th decades. Mean follow up considered as appropriate was more than 11 years to determine a definitive response to the treatment, although it is known that glomus tumors have slow growth rate and some reports mention a recurrence of tumors even after twenty years 9 .…”

Section: Discussioncontrasting

confidence: 89%

“…Perioperative mortality varied from 2.7 to 3% 4,21 . Surgery resulted in cure of the disease in 54 to 85% of the cases 4,9,16 , however, long-term effectiveness still needs to be determined.…”

Section: Discussionmentioning

confidence: 99%

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Tratamento radioterápico dos tumores glômicos do osso temporal

Dall’Igna

Antunes²,

Dall'Igna

2005

Rev. Bras. Otorrinolaringol.

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The treatment of glomic tumors has been controversial since its first description. It can be done with surgery, radiotherapy or just expectation. Aim: The objective of this paper was to evaluate the effectiveness and complications of radiotherapy. Study design: clinical with transversal cohort. Material and Method: It was made a retrospective review in the charts of the patients with glomus jugulare tumors treated with radiotherapy. Disease control was determined by (1) no progression of symptoms or cranial nerve dysfunction or (2) no progression of the lesion in radiological follow-up. It was also evaluated the follow-up period and the sequelae of the treatment. Results: Twelve patients were included, 8 of then women. The follow-up period was from 3 to 35 years, with a media of 11,6 years. The main symptoms were: hearing loss, pulsate tinnitus, dizziness and vertigo. The signs were pulsate retrotympanic mass, facial palsy and cofosis. The tumors were staged using Fisch's classification. The radiotherapy was performed with linear accelerator with dose ranging from 4500-5500 in 4-6 weeks. In the follow-up period were possible to identify sequelaes like dermatitis, meatal stenosis, cofosis and facial palsy. Discussion: The signs and symptoms were the same found in the medical literature. The type and dosages of the radiotherapy were also the same of others reports. All patients had improvement of the symptoms and only one was not considered as having disease controlled. Complications were, in general, minor complications, with exception of the cofosis and facial palsy. Conclusion: Radiotherapy is a viable alternative to treatment of these tumors because their good response and low level of complications. It should be considered specially in advanced tumors where a surgical procedure could bring a high level of morbidity.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussioncontrasting

confidence: 89%

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Tratamento radioterápico dos tumores glômicos do osso temporal

Dall’Igna

Antunes²,

Dall'Igna

2005

Rev. Bras. Otorrinolaringol.

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“…In certain cases of malignant paraganglioma, surgery cannot completely encompass the lesion. 33 In these instances of incomplete removal, adjuvant radiation therapy may improve survival by slowing the growth of residual tumor. An examination of the individuals in the current study who were followed until their death supports this hypothesis.…”

Section: Treatmentmentioning

confidence: 99%

National Cancer Data Base report on malignant paragangliomas of the head and neck

Lee¹,

Barich²,

Karnell³

et al. 2002

Cancer

365

351

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BACKGROUNDMalignant paragangliomas of the head and neck are rare, with previous reports limited to nine or fewer patients. The current review included 59 cases extracted from the National Cancer Data Base that were diagnosed between 1985–1996.METHODS The primary criterion for inclusion in the current study was verified metastatic spread from a paraganglioma of the head and neck. Patterns of presentation and treatment as well as clinically relevant associations were demonstrated in contingency tables. Relative survival was used for analysis of outcome.RESULTSThe average patient age at presentation was 44 years, and gender distribution was equivalent. Metastases were confined to regional lymph nodes in the majority of cases (68.6%), with carotid body tumors found to have an even higher rate of regional confinement (93.8%). Surgery was the most common treatment (76.3%). The use of adjuvant irradiation for regionally confined disease increased across time, from 27% (1985–1990) to 46% (1991–1996). The 5‐year relative survival rate was 59.5% (76.8% for regionally confined carcinoma and 11.8% for distant metastasis). Among patients who were followed until death, those treated with adjuvant irradiation had a longer median survival (45 months) compared with those patients who were treated with surgery alone (12 months).CONCLUSIONS Malignant paraganglioma represents metastatic spread of a tumor type that, when restricted to the site of origin, is considered benign. Metastases from malignant paragangliomas of the head and neck usually are regionally confined. The primary management of a recognized malignancy should be directed toward complete surgical removal of the primary tumor and regional lymph nodes. Postoperative irradiation may be beneficial in slowing the progression of residual disease. Cancer 2002;94:730–7. © 2002 American Cancer Society.DOI 10.1002/cncr.10252

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“…Patient cure is provided only by surgical resection of the tumor and is connected with various degrees of postoperative morbidity.2 Radiotherapy, on the other hand, provides control of the disease by preventing further tumor growth. 3,4 While no controversy exists about the dominant role of surgery in the treatment of glomus tympanicum tumors,3'5'6 the advantage of surgery for glomus jugulare tumors, particularly those with intracranial extension, is challenged by radiotherapists. [3][4][5]7,8 They claim that radiation therapy is an effective treatment for glomus jugulare tumor with minimal late progression of disease in adequately treated patients (4500 to 5000 cGy) and no significant long-term complications.3…”

Section: Long-term Results Of Surgery For Temporal Bone Paragangl Iomamentioning

confidence: 99%