Long-term Outcomes After Radiosurgery for Temporal Bone Paragangliomas

Am J Clin Oncol. 2018 Mar;41(3):223-226. doi: 10.1097/COC.0000000000000255.

Abstract

Objectives: To determine the long-term outcome after stereotactic radiosurgery (SRS) for temporal bone paragangliomas.

Materials and methods: We retrospectively reviewed the medical records of 11 patients with temporal bone paragangliomas (10 patients with a glomus jugulare tumor and 1 patient with a glomus tympanicum tumor) treated between January 1997 and July 2012 at the University of Florida with SRS to a median dose of 15 Gy in 1 fraction. Ten previously unirradiated patients received SRS as did 1 patient who received prior fractionated radiotherapy (FRT) and then received salvage SRS for a local recurrence. The major outcome endpoint was local control, meaning no further growth or shrinkage on follow-up computed tomography or magnetic resonance imaging scans.

Results: The median follow-up time was 5.3 years. Two patients developed a local recurrence after SRS, including the patient who received salvage SRS after prior FRT. The overall local control rates at 5 and 10 years were both 81%. The cause-specific survival rates at 5 and 10 years were both 88%. The distant metastasis-free survival rates at 5 and 10 years were both 100%. The overall survival rates at 5 and 10 years were both 78%. There were no severe complications.

Conclusions: SRS for benign head and neck paragangliomas is a safe and efficacious treatment associated with minimal morbidity. SRS is suitable for patients with skull base tumors <3 cm when FRT is logistically unsuitable. Surgery is reserved for patients in good health whose risk of associated morbidity is low. Observation is a reasonable option for asymptomatic patients with a limited life expectancy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Middle Aged
  • Paraganglioma, Extra-Adrenal / mortality
  • Paraganglioma, Extra-Adrenal / surgery*
  • Radiosurgery / methods*
  • Radiosurgery / mortality
  • Retrospective Studies
  • Skull Neoplasms / mortality
  • Skull Neoplasms / surgery*
  • Temporal Bone / pathology
  • Treatment Outcome