title: Carotid body paragangliomas: a systematic study on management with surgery and radiotherapy.
abstract: The definitive universally accepted treatment for carotid body tumors (CBT) is surgery. The impact of surgery on cranial nerves and the carotid artery has often been underestimated. Alternatively, a few CBTs have been followed without treatment or irradiation. The goal of this study is to summarize the existing evidence concerning the efficacy and safety of surgery and external beam radiotherapy (EBRT) for CBT. Relevant articles were identified using strict criteria for systematic searches. Sixty-seven articles met the criteria which included 2,175 surgically treated patients. On the other hand, 17 articles including 127 patients treated with EBRT were found. Long-term control of the disease was obtained in 93.8% of patients who received surgical treatment and in 94.5% of the radiotherapy group. Surgery resulted in 483 (483/2,175 = 22.2%) new cranial nerve permanent deficits, whereas in the EBRT group, no new deficits were recorded (p = 0.004). The common/internal carotid artery was resected in 271 (12.5%) patients because of injury or tumor encasement, with immediate reconstruction in 212 (9.7%) patients. Three percent (60) of patients developed a permanent stroke and 1.3% (26) died due to postoperative complications. The major complications rates and the mortality after completion of the treatment also were significantly higher in surgical series compared to EBRT series. This systematic analysis highlights evidence that EBRT offers a similar chance of tumor control with lower risk of morbidity as compared to surgery in patients with CBT. This questions the traditional notion that surgery should be the mainstay of treatment.
authors: Department of Otolaryngology, Hospital Universitario Central de Asturias Oviedo, Oviedo, Spain.
authors: Carlos
authors: C
authors: Suárez
authors: Juan P
authors: JP
authors: Rodrigo
authors: William M
authors: WM
authors: Mendenhall
authors: Marc
authors: M
authors: Hamoir
authors: Carl E
authors: CE
authors: Silver
authors: Vincent
authors: V
authors: Grégoire
authors: Primož
authors: P
authors: Strojan
authors: Hartmut P H
authors: HP
authors: Neumann
authors: Rupert
authors: R
authors: Obholzer
authors: Christian
authors: C
authors: Offergeld
authors: Johannes A
authors: JA
authors: Langendijk
authors: Alessandra
authors: A
authors: Rinaldo
authors: Alfio
authors: A
authors: Ferlito
mesh_terms: D002345:Carotid Body Tumor / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome