Kita Sallabanda1,2, Hernan Barrientos3, Daniela Angelina Isernia Romero4, Cristian Vargas5, Jose Angel Gutierrez Diaz2, Carmen Peraza6, Eleonor Rivin Del Campo7, Juan Manuel Praena-Fernandez8, José Luis López-Guerra9. 1. 1 Department of Surgery, Complutense University, Madrid, Spain. 2. 2 Department of Neurosurgery, GenesisCare, Madrid, Spain. 3. 3 Department of Neurosurgery, Instituto Neurológico de Colombia, Medellín, Colombia. 4. 4 Máster Internacional en Aplicaciones Tecnológicas Avanzadas en Oncología Radioterápica de la Universidad de Murcia, GenesisCare Fundación, Madrid, Spain. 5. 5 Department of Epidemiology, Instituto Neurológico de Colombia, Medellín, Colombia. 6. 6 Department of Radiation Physics, GenesisCare, Madrid, Spain. 7. 7 Department of Radiation Oncology, Gustave Roussy Cancer Campus, Villejuif, Paris, France. 8. 8 Methodology Unit, University Hospital Virgen del Rocio, Seville, Spain. 9. 9 Department of Radiation Oncology, University Hospital Virgen del Rocio, Seville, Spain.
Abstract
AIMS AND BACKGROUND: The treatment of glomus jugulare tumors (GJT) remains controversial due to high morbidity. Historically, these tumors have primarily been managed surgically. The purpose of this retrospective review was to assess the tumor and clinical control rates as well as long-term toxicity of GJT treated with radiosurgery. METHODS: Between 1993 and 2014, 30 patients with GJT (31 tumors) were managed with radiosurgery. Twenty-one patients were female and the median age was 59 years. Twenty-eight patients (93%) were treated with radiosurgery, typically at 14 Gy ( n = 26), and 2 patients (7%) with stereotactic radiosurgery. Sixteen cases (52%) had undergone prior surgery. RESULTS: The mean follow-up was 4.6 years (range 1.5-12). Crude overall survival, tumor control, clinical control, and long-term grade 1 toxicity rates were 97%, 97%, 97%, and 13% (4/30), respectively. No statistically significant risk factor was associated with lower tumor control in our series. Univariate analysis showed a statistically significant association between patients having 1 cranial nerve (CN) involvement before radiosurgery and a higher risk of lack of improvement of symptoms (odds ratio 5.24, 95% confidence interval 1.06-25.97, p = .043). CONCLUSIONS: Radiosurgery is an effective and safe treatment modality for GJT. Patients having 1 CN involvement before radiosurgery show a higher risk of lack of improvement of symptoms.
AIMS AND BACKGROUND: The treatment of glomus jugulare tumors (GJT) remains controversial due to high morbidity. Historically, these tumors have primarily been managed surgically. The purpose of this retrospective review was to assess the tumor and clinical control rates as well as long-term toxicity of GJT treated with radiosurgery. METHODS: Between 1993 and 2014, 30 patients with GJT (31 tumors) were managed with radiosurgery. Twenty-one patients were female and the median age was 59 years. Twenty-eight patients (93%) were treated with radiosurgery, typically at 14 Gy ( n = 26), and 2 patients (7%) with stereotactic radiosurgery. Sixteen cases (52%) had undergone prior surgery. RESULTS: The mean follow-up was 4.6 years (range 1.5-12). Crude overall survival, tumor control, clinical control, and long-term grade 1 toxicity rates were 97%, 97%, 97%, and 13% (4/30), respectively. No statistically significant risk factor was associated with lower tumor control in our series. Univariate analysis showed a statistically significant association between patients having 1 cranial nerve (CN) involvement before radiosurgery and a higher risk of lack of improvement of symptoms (odds ratio 5.24, 95% confidence interval 1.06-25.97, p = .043). CONCLUSIONS: Radiosurgery is an effective and safe treatment modality for GJT. Patients having 1 CN involvement before radiosurgery show a higher risk of lack of improvement of symptoms.