Radiotherapy for Benign Head and Neck Paragangliomas: A 45-Year Experience

Paragangliomas of the head and neck are rare, slow-growing, generally benign tumors of neuroendocrine cells associated with the peripheral nervous system that commonly involve the carotid body, jugular bulb, vagal ganglia, and temporal bone. Treatment options include surgery, radiotherapy (RT), ster...

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Bibliographic Details
Published in:Cancer 2014-12, Vol.120 (23), p.3738-3743
Main Authors: GILBO, Philip, MORRIS, Christopher G, AMDUR, Robert J, WERNING, John W, DZIEGIELEWSKI, Peter T, KIRWAN, Jessica, MENDENHALL, William M
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Aortic Bodies
Biological and medical sciences
Carotid Body Tumor - radiotherapy
Cohort Studies
Disease-Free Survival
Female
Glomus
Glomus Jugulare Tumor - radiotherapy
Head and Neck Neoplasms - radiotherapy
Humans
Male
Medical sciences
Middle Aged
Neurology
Paraganglioma, Extra-Adrenal - radiotherapy
Radiotherapy, Intensity-Modulated
Retrospective Studies
Temporal Bone
Treatment Outcome
Tumors
Tumors of the nervous system. Phacomatoses
Young Adult
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Summary:Paragangliomas of the head and neck are rare, slow-growing, generally benign tumors of neuroendocrine cells associated with the peripheral nervous system that commonly involve the carotid body, jugular bulb, vagal ganglia, and temporal bone. Treatment options include surgery, radiotherapy (RT), stereotactic radiosurgery (SRS), and observation. This article briefly reviews our 45-year institutional experience treating this neoplasm with RT. From January 1968 through March 2011, 131 patients with 156 benign paragangliomas of the temporal bone, carotid body, jugular bulb, or glomus vagale were treated with RT at a median dose of 45 Gy in 25 fractions. The mean and median follow-up times were 11.5 years and 8.7 years, respectively. Five tumors (3.2%) recurred locally after RT, all within 10 years of treatment. The overall local control rates at 5 and 10 years were 99% and 96%, respectively. The cause-specific survival rates at 5 and 10 years were 98% and 97%, respectively. The distant-metastasis free survival rates at 5 and 10 years were 99% and 99%, respectively. The overall survival rates at 5 and 10 years were 91% and 72%, respectively. There were no severe complications. RT for benign head and neck paragangliomas is a safe and efficacious treatment associated with minimal morbidity. Surgery is reserved for patients in good health whose risk of associated morbidity is low. SRS may be suitable for patients with skull base tumors
ISSN:0008-543X
1097-0142
DOI:10.1002/cncr.28923