title: Leksell Gamma Knife radiosurgery of the jugulotympanic glomus tumor: long-term results.
abstract: OBJECTIVE
  Glomus tumors usually display indolent behavior, and the effectiveness of radiation in stopping their growth can be assessed after long-term follow-up. Currently only midterm results of radiosurgery are available, so the authors included patients treated by Gamma Knife at least 10 years ago in this study to obtain a perspective of long-term results.
  
  
  METHODS
  During the period from 1992 to 2003, the Gamma Knife was used to treat 46 patients with glomus tumors. The age of the patients ranged from 21 to 79 years (median 56 years). Gamma Knife radiosurgery was the primary treatment in 17 patients (37%). Open surgery preceded radiosurgery in 46% of cases, embolization in 17%, and fractionated radiotherapy in 4%. The volume of the tumor ranged from 0.2 to 24.3 cm(3) (median 3.6 cm(3)). The minimal dose to the tumor margin ranged between 10 and 30 Gy (median 20 Gy).
  
  
  RESULTS
  One patient was lost for follow-up after radiosurgery. Clinical follow-up was available in 45 patients and 44 patients were followed with MRI in a follow-up period that ranged from 12 to 217 months (median 118 months). Neurological deficits improved in 19 (42%) of 45 patients and deteriorated in 2 patients (4%). Tumor size decreased in 34 (77%) of 44 patients with imaging follow-up, while an increase in volume was observed in 1 patient (2%) 182 months after radiosurgery and Gamma Knife treatment was repeated. One patient underwent another Gamma Knife treatment for secondary induced meningioma close to the glomus tumor 98 months after initial radiosurgical treatment. Seven patients died 22-96 months after radiosurgery (median 48 months), all for unrelated reasons.
  
  
  CONCLUSIONS
  Radiosurgery has proved to be a safe treatment with a low morbidity rate and a reliable long-term antiproliferative effect.
authors.affiliation: Departments of 1 Stereotactic and Radiation Neurosurgery.
authors.forename: Roman
authors.initials: R
authors.lastname: Liscak
authors.forename: Dusan
authors.initials: D
authors.lastname: Urgosik
authors.forename: Tomas
authors.initials: T
authors.lastname: Chytka
authors.forename: Gabriela
authors.initials: G
authors.lastname: Simonova
authors.forename: Josef
authors.initials: J
authors.lastname: Novotny
authors.forename: Josef
authors.initials: J
authors.lastname: Vymazal
authors.forename: Khumar
authors.initials: K
authors.lastname: Guseynova
authors.forename: Vilibald
authors.initials: V
authors.lastname: Vladyka
mesh_terms: D000328:Adult; D000368:Aged; D004428:Ear Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005925:Glomus Jugulare Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005918:Glomus Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery; D043604:Glomus Tympanicum Tumor / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000401:mortality*; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Gamma Knife; complications; glomus jugulare tumor; long-term results; stereotactic radiosurgery