Kylie H Kang1,2, Emily S Lebow1,3, Andrzej Niemierko1,3, Marc R Bussière1,3, Nicholas A Dewyer3,4, Jillian Daly1, Michael J McKenna3,4, Daniel J Lee3,5, Jay S Loeffler1,3, Paul M Busse1,3, Helen A Shih1,3. 1. Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts. 2. Case Western Reserve University School of Medicine, Cleveland, Ohio. 3. Harvard Medical School, Boston, Massachusetts. 4. Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. 5. Department of Otology and Neurotology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts.
Abstract
BACKGROUND: Although slow growing, head and neck paragangliomas (HNPG) can cause significant morbidity. We evaluated the efficacy of proton therapy in the management of HNPG. METHODS: Retrospective review of an institutional proton therapy experience of treating patients between 1997 and 2016; 37 patients and 40 tumors were included. RESULTS: Proton therapy was delivered to a median of 50.4 Gy(RBE) (range: 45-68). Having a genetic/family predisposition for HNPG was associated with multifocal tumors (P = .02) and younger diagnosis age (P = .02). Twenty-six (70%) patients had symptom improvement posttreatment, and 65% of treated tumors showed ≥20% volumetric shrinkage. The 5-year recurrence-free and overall survival rates were both 97%. Grade 2 to grade 3 toxicities (54%) included subjective hearing impairment (19%), middle ear inflammation (14%), and dry mouth (8%). There were no grade 4-5 toxicities. CONCLUSIONS: Patients with HNPGs can be effectively and safely treated with proton therapy with excellent tumor control, successful volumetric tumor reduction, and symptomatic improvement.
BACKGROUND: Although slow growing, head and neck paragangliomas (HNPG) can cause significant morbidity. We evaluated the efficacy of proton therapy in the management of HNPG. METHODS: Retrospective review of an institutional proton therapy experience of treating patients between 1997 and 2016; 37 patients and 40 tumors were included. RESULTS: Proton therapy was delivered to a median of 50.4 Gy(RBE) (range: 45-68). Having a genetic/family predisposition for HNPG was associated with multifocal tumors (P = .02) and younger diagnosis age (P = .02). Twenty-six (70%) patients had symptom improvement posttreatment, and 65% of treated tumors showed ≥20% volumetric shrinkage. The 5-year recurrence-free and overall survival rates were both 97%. Grade 2 to grade 3 toxicities (54%) included subjective hearing impairment (19%), middle ear inflammation (14%), and dry mouth (8%). There were no grade 4-5 toxicities. CONCLUSIONS:Patients with HNPGs can be effectively and safely treated with proton therapy with excellent tumor control, successful volumetric tumor reduction, and symptomatic improvement.
Authors: Randall J Harley; Jason H Lee; Benjamin T Ostrander; Andrey Finegersh; Tammy B Pham; Kareem O Tawfik; Yin Ren; Farhoud Faraji; Rick A Friedman Journal: OTO Open Date: 2022-03-31
Authors: Karla Leach; Shikui Tang; Jared Sturgeon; Andrew K Lee; Ryan Grover; Parag Sanghvi; James Urbanic; Chang Chang Journal: Int J Part Ther Date: 2021-06-25