Fractionated stereotactic radiotherapy of glomus jugulare tumors. Local control, toxicity, symptomatology, and quality of life.
OBJECTIVE
For glomus jugulare tumors, the goal of treatment is microsurgical excision. To minimize postoperative neurologic deficits, stereotactic radiosurgery (SRS) was performed as an alternative treatment option. Stereotactic fractionated radiotherapy (SRT) could be a further alternative. This study aims at the assessment of local control, side effects, and quality of life (QoL).


METHODS
Between 1999-2005, 17 patients were treated with SRT. 11/17 underwent previous operations. 6/17 received primary SRT. Treatment was delivered by a linear accelerator with 6-MV photons. Median cumulative dose was 57.0 Gy. Local control, radiologic regression, toxicity, and symptomatology were evaluated half-yearly by clinical examination and MRI scans. QoL was assessed by Short Form-36 (SF-36).


RESULTS
Median follow-up was 40 months. Freedom from progression and overall survival for 5 years were 100% and 93.8%. Radiologic regression was seen in 5/16 cases, 11/16 patients were stable. Median tumor shrinkage was 17.9% (p=0.14). Severe acute toxicity (grade 3-4) or any late toxicity was never seen. Main symptoms improved in 9/16 patients, 7/16 were stable. QoL was not affected in patients receiving primary SRT.


CONCLUSIONS
SRT offers an additional treatment option of high efficacy with less side effects, especially in cases of large tumors, morbidity, or recurrences after incomplete resections.
Henzel
Martin
M
Department of Radiation Oncology, Philipps University of Marburg, Marburg, Germany. henzel@med.uni-marburg.de
Hamm
Klaus
K
Gross
Markus W
MW
Surber
Gunnar
G
Kleinert
Gabriele
G
Failing
Thomas
T
Sitter
Helmut
H
Strassmann
Gerd
G
Engenhart-Cabillic
Rita
R
D000368:Aged; D000369:Aged, 80 and over; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D005925:Glomus Jugulare Tumor / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods; D011879:Radiotherapy Dosage; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome