title: Stereotactic linear accelerater-based radiosurgery for the treatment of patients with glomus jugulare tumors.
abstract: BACKGROUND
  The optimal treatment for patients with glomus jugulare tumor (GJT) of the skull base remains controversial. Surgical excision is associated with a high incidence of cranial nerve injury, decreased quality of life, and high mortality. Fractionated radiotherapy is used to control the majority of these tumors, but disadvantages are a prolonged therapy interval and exposition of adjacent brain tissue to irradiation. The authors present the results of a study on 12 of 14 consecutively admitted patients who were treated using linear accelerator-based radiosurgery (LINAC-RS), an innovative method for the treatment of GJT.
  
  
  METHODS
  From May 1991 to March 2001, 14 patients with GJT were treated with stereotactic LINAC-RS for continued growth of tumor or of remaining tumor after surgery. Twelve patients (9 women and 3 men; age range, 28-71 years; median age, 59 years) with a median follow-up of 4 years (range, 0.8-9,0 years), were selected for retrospective analysis. A median single dose of 15 grays (Gy; range, 11-20 Gy) was applied to the surface of the tumor.
  
  
  RESULTS
  After undergoing LINAC-RS, 8 of 12 patients (67%) reported partial or complete subjective improvement, whereas complaints remained unchanged in 4 patients (33%). Neurologic status improved in 3 patients (25%) and remained unchanged in 8 patients (67%). Magnetic resonance images showed tumor shrinkage in 8 patients (67%) and no further progression in 4 patients (33%).
  
  
  CONCLUSIONS
  LINAC-RS is an effective and safe therapy for patients with GJT and may be used as an alternative to surgical resection. Compared with fractionated radiotherapy, LINAC-RS has some advantages. However, to clarify the question of long-term tumor control, longer observation times are required.
authors.affiliation: Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany. m.maarouf@uni-koeln.de
authors.forename: Mohammad
authors.initials: M
authors.lastname: Maarouf
authors.forename: Jürgen
authors.initials: J
authors.lastname: Voges
authors.forename: Peter
authors.initials: P
authors.lastname: Landwehr
authors.forename: Rainer
authors.initials: R
authors.lastname: Bramer
authors.forename: Harald
authors.initials: H
authors.lastname: Treuer
authors.forename: Martin
authors.initials: M
authors.lastname: Kocher
authors.forename: Rolf-Peter
authors.initials: RP
authors.lastname: Müller
authors.forename: Volker
authors.initials: V
authors.lastname: Sturm
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005925:Glomus Jugulare Tumor / Q000601:surgery*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome