Proton therapy for head and neck paragangliomas: A single institutional experience. Issue 4 (18th December 2019)

• Record Type: Journal Article
• Authors: Kang, Kylie H.; Lebow, Emily S.; Niemierko, Andrzej; Bussière, Marc R.; Dewyer, Nicholas A.; Daly, Jillian; McKenna, Michael J.; Lee, Daniel J.; Loeffler, Jay S.; Busse, Paul M.; Shih, Helen A.
• Is Part Of: Head & neck. Volume 42:Issue 4(2020)
• Page Start: 670
• Page End: 677
• Publication Date: 2019-12-18
• Subjects: head and neck -- outcomes -- paraganglioma -- proton therapy -- toxicities; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26044
• Languages: English
• ISSNs: 1043-3074

Abstract

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.