title: The role of radiation therapy in the management of head and neck paragangliomas: impact of quality of life versus treatment response.
abstract: OBJECTIVE
  To assess the impact of radiotherapy in paragangliomas (PGLs) with regard to overall survival, local control, volumetric response and particularly quality of life (QoL).
  
  
  METHODS
  From 1985 to 2010, 130 cases of head and neck (H&N) PGLs were managed at Bordeaux University Hospital. With a median follow-up of 7.6 years, we retrospectively present a cohort of 30 consecutive patients treated with radiation therapy for H&N PGLs. QoL was evaluated for 20 patients by the EORTC QLQ-C30 and H&N35 questionnaires through a cross-sectional study.
  
  
  RESULTS
  The 5-year overall survival and local control were 95% and 96% respectively. QoL is altered following management of PGLs. The H&N35 score is lower after combined modality therapy (surgery±embolization and radiation therapy) for speech and hearing (p=0.004), trismus (p=0.003) and total score (p=0.01) than after radiotherapy alone. Tumor shrinkage was significant at 2 and 3 years after radiotherapy (p=0.018; p=0.043).
  
  
  CONCLUSIONS
  Ultimate QoL should be a major goal of any treatment strategy for this benign disease. Definitive radiotherapy should be considered as a reasonable alternative to multimodality treatment as it provides comparable disease control with an apparent improvement in QoL.
authors.affiliation: Univ. de Bordeaux, France; CHU de Bordeaux, Department of Radiation Oncology, France; Massachusetts General Hospital, Department of Radiation Oncology, Harvard Medical School, Boston, USA. Electronic address: dr.sgalland@bordeauxnord.com.
authors.forename: Sigolène
authors.initials: S
authors.lastname: Galland-Girodet
authors.affiliation: Univ. de Bordeaux, France; CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Maire
authors.affiliation: CHU de Bordeaux, Department of Oto-Rhino-Laryngology and Skull Base Surgery, France.
authors.forename: Erwan
authors.initials: E
authors.lastname: De-Mones
authors.affiliation: CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Benech
authors.affiliation: CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Kheireddine
authors.initials: K
authors.lastname: Bouhoreira
authors.affiliation: CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Protat
authors.affiliation: CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Demeaux
authors.affiliation: Univ. de Bordeaux, France; CHU de Bordeaux, Department of Oto-Rhino-Laryngology and Skull Base Surgery, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Darrouzet
authors.affiliation: CHU de Bordeaux, Department of Radiation Oncology, France.
authors.forename: Aymeri
authors.initials: A
authors.lastname: Huchet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000503:physiopathology / Q000523:psychology / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000532:radiotherapy*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Head and neck paragangliomas; Quality of life; Radiation therapy; Tumor response