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

  • Original Article - Functional Neurosurgery - Other
  • Published:
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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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Authors and Affiliations

  1. Department of Neurological Surgery, The Charles Clore Hospitalization Tower, West Wing Sheba Medical Center, Ramat Gan, Israel

    Ungar Lior, Hershkovitch Rotem, Nissim Uzi & Spiegelmann Roberto

  2. Chaim Sheba Medical Center, 52621 Tel HaShomer, Ramat Gan, Israel

    Ungar Lior

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  1. Ungar Lior
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  2. Hershkovitch Rotem
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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.

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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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Lior, U., Rotem, H., Uzi, N. et al. LINAC radiosurgery for glomus jugulare tumors: retrospective – cohort study of 23 patients. Acta Neurochir 162, 839–844 (2020). https://doi.org/10.1007/s00701-020-04251-7

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