Stereotactic linear accelerater-based radiosurgery for the treatment of patients with glomus jugulare tumors.
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.
Maarouf
Mohammad
M
Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany. m.maarouf@uni-koeln.de
Voges
Jürgen
J
Landwehr
Peter
P
Bramer
Rainer
R
Treuer
Harald
H
Kocher
Martin
M
Müller
Rolf-Peter
RP
Sturm
Volker
V
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