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LINAC radiosurgery for glomus jugulare tumors: retrospective – cohort study of 23 patients

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Abstract

Background

Glomus jugulare tumors (GJTs) are uncommon and locally disruptive tumors that usually arise within the jugular foramen of the temporal bone. Surgery was the treatment of choice up until recently. In the last decades, however, radiosurgery has surfaced as a promising alternative treatment by providing excellent tumor control with low risk of cranial nerve injuries. Our aim was to examine the results of radiosurgery specifically, linear accelerator stereotactic radiosurgery (LINAC SRS) for GJT treatment. We hypothesized that radiosurgery will reduce the size of the tumor and improve neurological symptoms.

Design and method

Between January 1, 1994 and December 31, 2013, 30 patients with GJTs were treated in Sheba Medical Center using LINAC SRS treatment. Comprehensive clinical follow-up was available for 23 patients. Sixteen patients were female and seven males with a median age of 64 years, with a range of 18–87 years. In 19 of the patients, LINAC SRS was the primary treatment, whereas in the remaining four cases, surgery or embolization preceded radiosurgery. The median treated dose to tumor margin was 14 Gy (range 12–27 Gy), and the median tumor volume before treatment was 5 ml (range 0.5–15 ml).

Results

Following the LINAC SRS treatment, 14 of 23 patients (60%) showed improvement of previous neurological deficits, nine patients (40%) remained unchanged. At the end of a follow-up, tumor reduction was seen in 13 patients and a stable volume in eight (91% tumor control rate). Two cases of tumor progression were noted. Three patients (13%) had post- SRS complications during the follow-up, two of which achieved tumor control, while in one the tumor advanced.

Conclusions

LINAC SRS is a practical treatment option for GJTs, with a high rate of tumor control and satisfactory neurological improvement.

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References

  1. 1.

    de Andrade EM, Brito JR, Mario SD, de Melo SM, Benabou S (2013) Stereotactic radiosurgery for the treatment of glomus jugulare tumors. Surg Neurol Int 4(Suppl 6):S429–S435

  2. 2.

    Elshaikh MA, Mahmoud-Ahmed AS, Kinney SE et al (2002) Recurrent head-and-neck chemodectomas: a comparison of surgical and radiotherapeutic results. Int J Radiat Oncol Biol Phys 52(4):953–956

  3. 3.

    Eustacchio S, Leber K, Trummer M, Unger F, Pendl G (1999) Gamma knife radiosurgery for glomus jugulare tumors. Acta Neurochir 141(8):811–818

  4. 4.

    Eustacchio S, Trummer M, Unger F, Schröttner O, Sutter B, Pendl G (2002) The role of gamma knife radiosurgery in the management of glomus jugulare tumours. Acta Neurochir Suppl 84:91–97. https://doi.org/10.1007/978-3-7091-61173_11

  5. 5.

    Feigenberg SJ, Mendenhall WM, Hinerman RW et al (2002) Radiosurgery for paraganglioma of the temporal bone. Head Neck 24(4):384–389

  6. 6.

    Fisch U (1987) Possibilities of microsurgery of the petrous bone and the base of the skull. Ther Umsch 44(2):102–108

  7. 7.

    Foote RL, Coffey RJ, Gorman DA et al (1997) Stereotactic radiosurgery for glomus jugulare tumors: a preliminary report. Int J Radiat Oncol Biol Phys 38(3):491–495

  8. 8.

    Gandía-González ML, Kusak ME, Moreno NM et al (2014) Jugulotympanic paragangliomas treated with gamma knife radiosurgery: a single-center review of 58 cases. J Neurosurg 121(5):1158–1165

  9. 9.

    Ganz JC, Abdelkarim K (2009) Glomus jugulare tumours: certain clinical and radiological aspects observed following gamma knife radiosurgery. Acta Neurochir 151(5):423–426

  10. 10.

    Genç A, Bicer A, Abacioglu U et al (2010) Gamma knife radiosurgery for the treatment of glomus jugulare tumors. J Neuro-Oncol 97(1):101–108

  11. 11.

    Gerosa M, Visca A, Rizzo P et al (2006) Glomus jugulare tumors: the option of gamma knife radiosurgery. Neurosurgery 59(3):561–569 discussion 561-9

  12. 12.

    Gilbo P, Morris CG, Amdur RJ et al (2014) Radiotherapy for benign head and neck paragangliomas: a 45-year experience. Cancer 120(23):3738–3743

  13. 13.

    Gottfried ON, Liu JK, Couldwell WT (2004) Comparison of radiosurgery and conventional surgery for the treatment of glomus jugulare tumors. Neurosurg Focus 17(2):E4

  14. 14.

    Ibrahim R, Ammori MB, Yianni J, el al (2017) Gamma knife radiosurgery for glomus jugulare tumors: a single- center series of 75 cases. J Neurosurg 126 (5):1488–1497

  15. 15.

    Ivan ME, Sughrue ME, Clark AJ, Kane AJ et al (2011) A meta-analysis of tumor control rates and treatment-related morbidity for patients with glomus jugulare tumors. J Neurosurg 114(5):1299–1305

  16. 16.

    Jackson CG, Glasscock ME 3rd, Nissen AJ, Schwaber MK (1982) Glomus tumor surgery: the approach, results, and problems. Otolaryngol Clin N Am 15(4):897–916

  17. 17.

    Jansen JC, van den Berg R, Kuiper A et al (2000) Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal. Cancer 88(12):2811–2816

  18. 18.

    Lee CC, Pan DH, Wu JC et al (2011) Gamma knife radiosurgery for glomus jugulare and tympanicum. Stereotact Funct Neurosurg 89(5):291–298

  19. 19.

    Lim M, Gibbs IC, Adler JR Jr, Chang SD (2004) Efficacy and safety of stereotactic radiosurgery for glomus jugulare tumors. Neurosurg Focus 17(2):E11

  20. 20.

    Liscak R, Vladyka V, Wowra B et al (1999) Gamma knife radiosurgery of the glomus jugulare tumour - early multicentre experience. Acta Neurochir 141(11):1141–1146

  21. 21.

    Liscak R, Urgosik D, Chytka T et al (2014) Leksell gamma knife radiosurgery ofjugulotympanic glomus tumor: long-term results. J Neurosurg 121(suppl):198–202

  22. 22.

    Maarouf M, Voges J, Landwehr P et al (2003) Stereotactic linear accelerator-based radiosurgery for the treatment of patients with glomus jugulare tumors. Cancer 97(4):1093–1098

  23. 23.

    Martín IT, Ávila Rdel M, Herrera MZ et al (2016) Role of radiosurgery in the management of glomus tumors. Head Neck 38(suppl 1):E798–E804

  24. 24.

    Miller JP, Semaan MT, Maciunas RJ, Einstein DB, Megerian CA (2009) Radiosurgery for glomus jugulare tumors. Otolaryngol Clin N Am 42(4):689–706

  25. 25.

    Navarro Martín A, Maitz A, Grills IS et al (2010) Successful treatment of glomus jugulare tumours with gamma knife radiosurgery: clinical and physical aspects of management and review of the literature. Clin Transl Oncol 12(1):55–62

  26. 26.

    Netterville JL, Jackson CG, Miller FR et al (1998) Vagal paraganglioma: a review of 46 patients treated during a 20-year period. Arch Otolaryngol Head Neck Surg 124(10):1133–1140

  27. 27.

    Pareschi R, Righini S, Destito D et al (2003) Surgery of Glomus Jugulare tumors. Skull Base 13(3):149–157

  28. 28.

    Patel NS, Link MJ, Driscoll CLW, et at (2018) Hearing outcomes after stereotactic radiosurgery for jugular paraganglioma. Otol Neurotol 39(1):99–105

  29. 29.

    Pollock BE (2004) Stereotactic radiosurgery in patients with glomus jugulare tumors. Neurosurg Focus 17(2):E10

  30. 30.

    Poznanovic SA, Cass SP, Kavanagh BD (2006) Short-term tumor control and acute toxicity after stereotactic radiosurgery for glomus jugulare tumors. Otolaryngol Head Neck Surg 134(3):437–442

  31. 31.

    Sager O, Beyzadeoglu M, Dincoglan F et al (2014) Evaluation of linear accelerator-based stereotactic radiosurgery in the management of glomus jugulare tumors. Tumori 100(2):184–188

  32. 32.

    Sallabanda K, Barrientos H, Isernia Romero DA et al (2018) Long-term outcomes after radiosurgery for glomus jugulare tumors. Tumori 104(4):300–306

  33. 33.

    Sharma MS, Gupta A, Kale SS et al (2008) Gamma knife radiosurgery for glomus jugulare tumors: therapeutic advantages of minimalism in the skull base. Neurol India 56(1):57–61

  34. 34.

    Sheehan J, Kondziolka D, Flickinger J, Lunsford LD (2005) Gamma knife surgery for glomus jugulare tumors: an intermediate report on efficacy and safety. J Neurosurg 102(Suppl):241–246

  35. 35.

    Sheehan JP, Tanaka S, Link MJ et al (2012) Gamma knife surgery for the management of glomus tumors: a multicenter study. J Neurosurg 117(2):246–254

  36. 36.

    Shiu AS, Kooy HM, Ewton JR et al (1997) Comparison of miniature multileaf collimation (MMLC) with circular collimation for stereotactic treatment. Int J Radiat Oncol Biol Phys 37(3):679–688

  37. 37.

    Suárez C, Rodrigo JP, Bödeker CC et al (2013) Jugular and vagal paragangliomas: systematic study of management with surgery and radiotherapy. Head Neck 35(8):1195–1204

  38. 38.

    Tran Ba Huy P (2014) Radiotherapy for glomus jugulare paraganglioma. Eur Ann Otorhinolaryngol Head Neck Dis 131(4):223–226

  39. 39.

    van Hulsteijn LT, Corssmit EP, Coremans IE et al (2013) Regression and local control rates after radiotherapy for jugulotympanic paragangliomas: systematic review and meta-analysis. Radiother Oncol 106(2):161–168

  40. 40.

    Varma A, Nathoo N, Neyman G et al (2006) Gamma knife radiosurgery for glomus jugulare tumors: volumetric analysis in 17 patients. Neurosurgery 59(5):1030–1036 discussion 1036

  41. 41.

    Wong BJ, Roos DE, Borg MF (2014) Glomus jugulare tumours: a 15 year radiotherapy experience in South Australia. J Clin Neurosci 21(3):456–461

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Correspondence to Ungar Lior.

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The authors declare that the research was conducted in the absence of any involvement with organization or entity with any financial interest or non-financial interest.

Statement of human rights

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the Helsinki and Sheba Medical center research committee (approval number 3207–16-SMC).

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This article is part of the Topical Collection on Functional Neurosurgery – Other.

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Lior, U., Rotem, H., Uzi, N. et al. LINAC radiosurgery for glomus jugulare tumors: retrospective – cohort study of 23 patients. Acta Neurochir (2020). https://doi.org/10.1007/s00701-020-04251-7

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Keywords

  • Linear accelerator stereotactic radiosurgery (LINAC SRS)
  • Glomus jugulare tumor (GJT)