Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas. Issue 2 (13th October 2020)

• Record Type: Journal Article
• Authors: Patel, Ankur K.; Rodríguez‐López, Joshua L.; Hirsch, Barry E.; Burton, Steven A.; Flickinger, John C.; Clump, David A.
• Is Part Of: Head & neck. Volume 43:Issue 2(2021)
• Page Start: 449
• Page End: 455
• Publication Date: 2020-10-13
• Subjects: glomus jugulare -- linear accelerator -- paraganglioma -- radiosurgery -- SRS; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26497
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: Data supporting linear accelerator (linac) stereotactic radiosurgery (SRS) for jugulotympanic paragangliomas (JTPs) come from small series with minimal follow‐up. Herein, we report a large series of JTPs with extended follow‐up after frameless linac‐based SRS. Methods: JTPs treated with linac‐based SRS from 2002 to 2019 with 1+ follow‐up image were reviewed for treatment failure (radiographic or clinical progression, or persistent symptoms after SRS requiring intervention) and late toxicities (CTCAE v5.0). Results: Forty JTPs were identified; 30 were treated with a multifraction regimen. Median clinical and radiographic follow‐up was 79.7 (interquartile range [IQR] 31.7‐156.9) and 54.4 months (IQR 17.9‐105.1), respectively, with a median 4.5 follow‐up scans (IQR 2‐9). Seven‐year progression‐free survival (PFS) was 97.0% (95% confidence interval 91.1%‐100.0%). PFS was similar between single‐ and multifraction regimens (log rank P = .99). Toxicity was seen in 7.7% (no grade III). Conclusions: With extended clinical and radiographic follow‐up, frameless linac‐based SRS provides excellent local control with mild toxicity <8%.