Radiosurgery of Glomus Tumors of Temporal Bone: a Meta-analysis

Purpose: To update our experience treating benign head-and-neck paragangliomas (PGs) with radiotherapy (RT). Methods: A total of 149 patients with 176 PGs received curative-intent RT; 126 received RT to 1 PG and 23 to 2 or more PGs. The most common dose fractionation schedule was 45 Gy/25 once-daily fractions/5 weeks which was used to treat 147 PGs (83.5%) in 123 patients (82.6%). Patients were followed with physical examination and CT/MRI. The median follow-up for all patients was 10.6 years (range, 0.2-50.4 years); the median follow-up for surviving patients was 11.1 years (range, 0.2-50.4). Results: The 5-year, 10-year, and 15-year outcomes were: local control, 99%, 96%, and 95%; distant metastasis-free survival, 99%, 99%, and 99%; cause-specific survival, 98%, 98%, and 98%; and overall survival, 90%, 75%, and 64%, respectively. No patient developed a moderate or severe complication, or a radiationinduced second tumor or malignant transformation of the benign PG. Conclusion: RT is an effective treatment for head-and-neck PGs with a low risk of complications. K E Y W O R D Sbenign cancer, outcomes, paragangliomas, radiotherapy

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“…SRS is a reasonable option for skull base PGs 3 cm or less in size . The advantage of SRS is convenience.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy for benign head and neck paragangliomas

et al. 2019

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“…A postoperative MRI shows a subtotal resection showing an important brainstem decompression, leaving the extradural component of the tumor (De Brito et al, 2018). The residual was treated with radiotherapy (Sahyouni et al, 2018;Shapiro et al, 2018).…”

Section: Abstract Glomus Jugulare; Brainstem Compression; Jugular Formentioning

confidence: 99%

Management of a complex glomus jugulare tumor with severe brainstem compression

Mendez-Rosito

Guerrero

Heredia

et al. 2019

Neurosurgical Focus: Video

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Surgery of glomus jugulare tumors is complex, but when these tumors have a large intradural component and cause brainstem compression they became a challenge to the surgeon. It is crucial to preoperatively understand the anatomy of the tumor and analyze its relationship with the temporal bone, facial nerve, and foramen jugular neurovascular structures. We present a case of a male patient with a complex glomus jugulare tumor causing severe brainstem compression. Nuances of technique and surgical pearls related to the management of complex jugulare tumors are discussed and illustrated in this operative video.The video can be found here: https://youtu.be/oCjzp0kFRGc.

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“…Various techniques and platforms are available to deliver SRS for JTPs, including Gamma Knife SRS and linear accelerator (linac)‐based SRS. Although no randomized trials have compared surgery to SRS in the management of JTPs, the efficacy of SRS is supported by multiple retrospective series and meta‐analyses reporting local control rates of 80% to 100% 8‐11 . However, most robust SRS series with long follow‐up include patients treated with Gamma Knife SRS 12,13 .…”

Section: Introductionmentioning

confidence: 99%

Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas

et al. 2020

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Background: Data supporting linear accelerator (linac) stereotactic radiosurgery (SRS) for jugulotympanic paragangliomas (JTPs) come from small series with minimal follow-up. Herein, we report a large series of JTPs with extended follow-up after frameless linac-based SRS. Methods: JTPs treated with linac-based SRS from 2002 to 2019 with 1+ follow-up image were reviewed for treatment failure (radiographic or clinical progression, or persistent symptoms after SRS requiring intervention) and late toxicities (CTCAE v5.0). Results: Forty JTPs were identified; 30 were treated with a multifraction regimen. Median clinical and radiographic follow-up was 79.7 (interquartile range [IQR] 31.7-156.9) and 54.4 months (IQR 17.9-105.1), respectively, with a median 4.5 follow-up scans (IQR 2-9). Seven-year progression-free survival (PFS) was 97.0% (95% confidence interval 91.1%-100.0%). PFS was similar between single-and multifraction regimens (log rank P = .99). Toxicity was seen in 7.7% (no grade III). Conclusions: With extended clinical and radiographic follow-up, frameless linac-based SRS provides excellent local control with mild toxicity <8%.

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Radiosurgery of Glomus Tumors of Temporal Bone: a Meta-analysis

Cited by 22 publications

References 31 publications

Radiotherapy for benign head and neck paragangliomas

Radiotherapy for benign head and neck paragangliomas

Management of a complex glomus jugulare tumor with severe brainstem compression

Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas

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