title: Paragangliomas: presentation and management by radiotherapy at the Prince of Wales Hospital.
abstract: BACKGROUND
  Paragangliomas are commonly treated with surgery, while radiotherapy is reserved for those that are inoperable or have relapsed. However, this retrospective study aims to determine whether radiotherapy is a viable initial treatment for paragangliomas.
  
  
  METHODS
  Of 73 tumours researched, 44 were diagnosed and treated from January 1967 to December 2012 at the Radiation Oncology Department at the Prince of Wales Hospital and thus were eligible for analysis. Median follow-up time was 3.5 years with a range of 1 to 40 years. Thirty-four tumours were treated with radiotherapy only, and 10 tumours were treated with both surgical resection and radiotherapy. Local control and cause-specific survival were the primary end points measured.
  
  
  RESULTS
  Five-year local control rate for the population of 44 lesions was 89%; it was 100% in the group treated by radiotherapy alone, but only 50% in the group treated by surgery followed by radiotherapy, with radiation used for salvage. The difference in control rates between these two subset groups was found to be statistically significant (P < 0.001). Cause-specific survival rates for this eligible population at 5 and 10 years were 98% and 90%, respectively. After initial radiotherapy, 4 patients had improved cranial nerve function, there was clinical improvement in tinnitus, and one new cranial nerve deficit developed where a high dose was used.
  
  
  CONCLUSIONS
  Radiotherapy has high local control rates and few complications. The local control and complication rates compare favourably to surgery.
authors.affiliation: Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, New South Wales, Australia; University of New South Wales Clinical Teaching School, Prince of Wales Hospital, Sydney, New South Wales, Australia; Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia.
authors.forename: Robert I
authors.initials: RI
authors.lastname: Smee
authors.forename: Jayana
authors.initials: J
authors.lastname: Jayasekara
authors.forename: Janet R
authors.initials: JR
authors.lastname: Williams
authors.forename: Claire
authors.initials: C
authors.lastname: Hanna
mesh_terms: D001930:Brain Injuries / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D003390:Cranial Nerve Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010235:Paraganglioma / Q000473:pathology / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome
keywords: head and neck; local control; paraganglioma; radiotherapy; surgery