Original Article

Neurological Sciences

, 30:479

First online:

Paragangliomas of head and neck: a treatment option with CyberKnife radiosurgery

  • Livia C. BianchiAffiliated withCyberKnife Center CDI
  • , Marcello MarchettiAffiliated withDepartment of Neurosurgery, Division of Radiotherapy, Fondazione IRCCS Istituto Neurologico Carlo BestaDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta Email author 
  • , Lorenzo BraitAffiliated withCyberKnife Center CDI
  • , Achille BergantinAffiliated withCyberKnife Center CDI
  • , Ida MilanesiAffiliated withDepartment of Neurosurgery, Division of Radiotherapy, Fondazione IRCCS Istituto Neurologico Carlo Besta
  • , Giovanni BroggiAffiliated withDepartment of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo BestaCyberKnife Center CDI
  • , Laura FariselliAffiliated withDepartment of Neurosurgery, Division of Radiotherapy, Fondazione IRCCS Istituto Neurologico Carlo BestaCyberKnife Center CDI

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Abstract

Paragangliomas are highly vascular and predominantly benign neoplasms that have traditionally been treated by surgery, embolization and/or external beam radiotherapy (EBRT). The aim of this study is to evaluate the short-term local tumor control and safety of CyberKnife radiosurgery for these lesions. Nine patients, eight with jugular glomus paragangliomas and one with a carotid body paraganglioma, were treated. The target contouring was performed on merged CT and MR images. Eight patients were treated with doses ranging from 11 to 13 Gy (mean 12.5 Gy) in a single fraction and one with 24 Gy in three fractions prescribed to 72–83% isodose line. The mean follow-up was 20 months. One patient died from unrelated causes. There were no local recurrences. All eight patients also demonstrated neurological stability or improvement. Neither cranial nerve palsies have arisen, nor has deterioration beyond baseline been observed. In conclusion, CyberKnife radiosurgery appears to be both safe and effective in the treatment of skull base paragangliomas. Determining whether long-term complications will arise will require further investigation.

Keywords

Paragangliomas Fractionated radiotherapy Radiosurgery CyberKnife