Long‐term results of treatment for glomus jugulare and glomus vagale tumors with radiotherapy

Cole, James M.; Beiler, David D.

doi:10.1288/00005537-199412000-00006

Cited by 113 publications

(90 citation statements)

References 12 publications

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“…Overall survival is similar to that of the general population (de Flines et al 2011), albeit with reduced quality of life (Havekes et al 2008), so this is not a useful end point for comparison. Therefore, the optimal management of HNPGLs has generated considerable debate over the years, and recommendations have varied from the routine use of radiotherapy (Verniers et al 1992, Cole & Beiler 1994 to simple observation for most patients (van der Mey et al 1992).…”

Section: Choice Of Therapymentioning

confidence: 99%

The management of head-and-neck paragangliomas

Căpățînă

Ntali

Karavitaki

et al. 2013

Endocrine-Related Cancer

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Paragangliomas (PGLs) are tumours originating from neural crest-derived cells situated in the region of the autonomic nervous system ganglia. Head-and-neck PGLs (HNPGLs) originate from the sympathetic and parasympathetic paraganglia, most frequently from the carotid bodies and jugular, tympanic and vagal paraganglia, and are usually non-catecholamine secreting. Familial PGLs are considered to be rare, but recently genetic syndromes including multiple PGLs and/or phaeochromocytomas have been more thoroughly characterised. Nowadays, genetic screening for the genes frequently implicated in both familial and sporadic cases is routinely being recommended. HNPGLs are mostly benign, generally slow-growing tumours. Continuous growth leads to the involvement of adjacent neurovascular structures with increased morbidity rates and treatment-related complications. Optimal management mostly depends on tumour location, local involvement of neurovascular structures, estimated malignancy risk, patient age and general health. Surgery is the only treatment option offering the chance of cure but with significant morbidity rates, so a more conservative approach is usually considered, especially in the more difficult cases. Radiotherapy (fractionated or stereotactic radiosurgery) leads to tumour growth arrest and symptomatic improvement in the short term in many cases, but the longterm consequences are unclear. Early detection is essential in order to increase the chance of cure with a lower morbidity rate. The constant improvement in diagnostic imaging, surgical and radiation techniques has led to a safer management of these tumours, but there are still many therapeutic challenges, and no treatment algorithm has been agreed upon until now. The management of HNPGLs requires a multidisciplinary effort addressing the genetic, surgical, radiotherapeutic, oncological, neurological and endocrinological implications. Further progress in the understanding of their pathogenesis will lead to more effective screening and earlier diagnosis, both critical to successful treatment.

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Section: Choice Of Therapymentioning

confidence: 99%

The management of head-and-neck paragangliomas

Căpățînă

Ntali

Karavitaki

et al. 2013

Endocrine-Related Cancer

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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: Discussionmentioning

confidence: 99%

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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“…Recurrence can appear after more than 20 years, even after an apparently total removal of the tumor [2,3,20]. A five-year follow-up cannot be considered sufficient to judge the success of the treatment and small residual tumor tissue, undetectable on CT or MRI can often be visualized only on angiography [2,21].…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, the tumor is decreased in size on average in only 23% [14]. Radiotherapy is associated with a less dangerous morbidity in 7% of cases [21]. More severe complications, such as bone necrosis or necrosis of nerve tissue, have been observed in 2-3% of cases [19,23].…”

Section: Discussionmentioning

confidence: 99%

Leksell Gamma Knife Radiosurgery of the Tumor Glomus Jugulare and Tympanicum

Liščák

Vladyka

Šimonová

et al. 1998

Stereotact Funct Neurosurg

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We have treated 14 patients with glomus tumor during the 4 years (of 1993 to 1997) using Leksell Gamma Knife radiosurgery. The male: female ratio was 1:3.7, and the mean age 48.6 years (range 22–75 years). The mean tumor volume was 5.5 cm³ (range 0.7–11.3 cm³). The mean maximum dose was 37.4 Gy (range 20–44 Gy). The mean margin dose was 19.4 Gy (range 10–25 Gy). In 3 patients, infrabasal spread of the tumor could not be delineated on peroperative stereotactic CT scans. As a result, this portion of the tumor was treated in 2 patients at a second stage using stereotactic MRI. Follow-up in 11 patients ranged from 6 to 42 months (mean 20.5 months). Hearing on the affected side was further impaired in 3 patients. Tinnitus, vertigo and ataxia improved in 3 patients, headache and nausea in 2 patients. Angiography after radiosurgery was performed in 3 patients. In one patient 12 months after the radiosurgery, pathological vascularisation had completely disappeared. In another patient pathological vascularisation was still present 22 months after the first stage, despite two-stage radiosurgery, although the tumor volume decreased 30%. In the last patient, vascularisation and tumor volume partially decreased 12 months after radiosurgery. The volume of the tumor decreased in 4 patients. No change in tumor volume has been observed in any of the other patients to date. Radiosurgery proves to be a safe treatment for glomus tumor with no acute morbidity. Because of its naturally slow growth rate, up to 10 years follow-up will probably be necessary to establish the therapeutic effectiveness of radiosurgery for glomus tumor.

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Long‐term results of treatment for glomus jugulare and glomus vagale tumors with radiotherapy

Cited by 113 publications

References 12 publications

The management of head-and-neck paragangliomas

The management of head-and-neck paragangliomas

Tratamento radioterápico dos tumores glômicos do osso temporal

Leksell Gamma Knife Radiosurgery of the Tumor Glomus Jugulare and Tympanicum

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