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Evaluation of linear accelerator-based stereotactic radiosurgery in the management of glomus jugulare tumors
Aims And Background:
Although mostly benign and slow-growing, glomus jugulare tumors have a high propensity for local invasion of adjacent vascular structures, lower cranial nerves and the inner ear, which may result in substantial morbidity and even mortality. Treatment strategies for glomus jugulare tumors include surgery, preoperative embolization followed by surgical resection, conventionally fractionated external beam radiotherapy, radiosurgery in the form of stereotactic radiosurgery or fractionated stereotactic radiation therapy, and combinations of these modalities. In the present study, we evaluate the use of linear accelerator (LINAC)-based stereotactic radiosurgery in the management of glomus jugulare tumors and report our 15-year single center experience.
Methods And Study Design:
Between May 1998 and May 2013, 21 patients (15 females, 6 males) with glomus jugulare tumors were treated using LINAC-based stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. The indication for stereotactic radiosurgery was the presence of residual or recurrent tumor after surgery for 5 patients, whereas 16 patients having growing tumors with symptoms received stereotactic radiosurgery as the primary treatment.
Results:
Median follow-up was 49 months (range, 3-98). Median age was 55 years (range, 24-77). Of the 21 lesions treated, 13 (61.9%) were left-sided and 8 (38.1%) were right-sided. Median dose was 15 Gy (range, 10-20) prescribed to the 85%-100% isodose line encompassing the target volume. Local control defined as either tumor shrinkage or the absence of tumor growth on periodical follow-up neuroimaging was 100%.
Conclusions:
LINAC-based stereotactic radiosurgery offers a safe and efficacious management strategy for glomus jugulare tumors by providing excellent tumor growth control with few complications.
Insights
Linear accelerator (LINAC)-based stereotactic radiosurgery provides 100% local control for glomus jugulare tumors. This safe and effective treatment minimizes complications, offering excellent tumor growth management.
Area of Science:
- Neurosurgery
- Radiation Oncology
- Oncology
Background:
- Glomus jugulare tumors, though often benign, pose significant risks due to local invasion of critical structures.
- Morbidity and mortality associated with glomus jugulare tumors necessitate effective treatment strategies.
- Current treatment options include surgery, embolization, and various radiotherapy techniques.
Purpose of the Study:
- To evaluate the efficacy and safety of linear accelerator (LINAC)-based stereotactic radiosurgery for glomus jugulare tumors.
- To report a 15-year single-center experience with this treatment modality.
Main Methods:
- A cohort of 21 patients with glomus jugulare tumors treated between May 1998 and May 2013 was analyzed.
- Patients received LINAC-based stereotactic radiosurgery, either as primary treatment (16 patients) or for residual/recurrent tumors (5 patients).
- Treatment involved a median dose of 15 Gy prescribed to the 85%-100% isodose line.
Main Results:
- The study included 21 patients (15 female, 6 male) with a median age of 55 years.
- The median follow-up duration was 49 months.
- 100% local control was achieved, defined by tumor shrinkage or absence of growth on neuroimaging.
Conclusions:
- LINAC-based stereotactic radiosurgery is a safe and effective treatment for glomus jugulare tumors.
- This approach provides excellent tumor growth control with a low complication rate.
- Stereotactic radiosurgery represents a valuable management strategy for glomus jugulare tumors.
