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Long-Term Outcomes in Head and Neck Paragangliomas Managed with Intensity-Modulated Radiotherapy.

Guillaume Rougier1,2, Adrien Rochand1, Rémi Bourdais1

  • 1Sorbonne Universités, Department of Radiation Therapy and Oncology, Hôpital Pitié-Salpêtrière Charles Foix, APHP, Paris, France.

The Laryngoscope
|May 31, 2022
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Summary

Intensity-modulated radiation therapy (IMRT) offers a safe and effective treatment for head and neck paragangliomas. This method achieved a 94.8% success rate with minimal toxicity, improving patient outcomes.

Keywords:
head and neckintensity modulatedparagangliomasradiation therapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Head and Neck Surgery

Background:

  • Head and Neck Paragangliomas traditionally treated with surgery, often leading to significant morbidity.
  • Conventional external radiation therapy shows comparable tumor control with low toxicity.
  • Intensity-modulated radiation therapy (IMRT) presents a potentially improved treatment modality.

Purpose of the Study:

  • To evaluate the safety and efficacy of IMRT for head and neck paragangliomas.
  • To assess treatment outcomes and toxicity profiles associated with IMRT.

Main Methods:

  • Retrospective monocentric study of 39 patients treated with IMRT (exclusive or post-operative) for tympanic, jugular, carotid, or vagal paragangliomas.
  • Data collected from medical records, including imaging, pathology, and treatment planning.
  • Success defined by RECIST criteria; toxicity assessed for acute and long-term effects.

Main Results:

  • 39 patients included: 18 tympanic/jugular, 11 carotid, 9 vagal paragangliomas.
  • IMRT used as exclusive treatment in 74.4% and post-operative in 25.6%.
  • 94.8% treatment success rate (37/39 patients) with a low toxicity profile and no major adverse events.

Conclusions:

  • IMRT demonstrates high efficacy and safety for head and neck paragangliomas.
  • IMRT is a suitable treatment option, whether as primary or adjuvant therapy.
  • This approach offers a favorable alternative to surgery, minimizing sequelae.