title: Clinical response and tumor control based on long-term follow-up and patient-reported outcomes in patients with chemodectomas of the skull base and head and neck region treated with highly conformal radiation therapy.
abstract: BACKGROUND
  The purpose of this study was to evaluate long-term outcome after radiation therapy (RT) for skull base or head-and-neck chemodectomas.
  
  
  METHODS
  We treated 39 patients with chemodectomas with RT. Patients were treated with either single dose stereotactic radiosurgery, fractionated stereotactic radiotherapy, or intensity modulated radiotherapy (IMRT), depending on the size and anatomy of the lesion. At primary diagnosis, 16 patients were treated with surgical resection (41%), 4 with interventional embolization (10%), and 19 with primary RT (49%). Single doses of 18 Gy/80% isodose were applied. For fractionated treatments delivered as primary RT, a median total dose of 57.6 Gy was delivered. Five patients were treated with re-irradiation, of which 4 were treated with fractionated regimens; total dose was 28.8 Gy, 30 Gy, 40 Gy, and 56 Gy in 1.8 to 2 Gy single fractions.
  
  
  RESULTS
  Clinical symptoms improved in 18 patients (46%), remained unchanged in 10 patients (26%), and worsening of sequelae was observed in only 1 patient, which was associated with tumor progression. Actuarial local control was 97% at 10 years. Overall survival was 89% at 5 years and 87% at 10 years. Deaths were not disease-related except in 3 patients with tumor progression. No secondary malignancies were observed.
  
  
  CONCLUSIONS
  RT has been established as a treatment alternative for patients with glomus tumors. Long-term local control is very high, with good clinical response to treatment.
authors: University Hospital of Heidelberg, Department of Radiation Oncology, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
authors: Stephanie E
authors: SE
authors: Combs
authors: Bahar
authors: B
authors: Salehi-Allameh
authors: Daniel
authors: D
authors: Habermehl
authors: Kerstin A
authors: KA
authors: Kessel
authors: Thomas
authors: T
authors: Welzel
authors: Jürgen
authors: J
authors: Debus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D010236:Paraganglioma, Extra-Adrenal / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D063868:Patient Outcome Assessment; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D020266:Radiotherapy, Conformal / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D019292:Skull Base Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult
keywords: chemodectomas; cranial nerve deficits; glomus tumors; local control; radiotherapy