The role of radiation therapy in the management of head and neck paragangliomas: Impact of quality of life versus treatment response

Galland-Girodet, S.; Maire, Jean-Philippe; De-Mones, E.; Benech, J.; Bouhoreira, Kheireddine; Protat, B.; Demeaux, Hélène; Darrouzet, V.; Huchet, A.

doi:10.1016/j.radonc.2014.06.002

Cited by 22 publications

(22 citation statements)

References 35 publications

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“…Several groups have also indicated excellent local tumor control, with rates between 85% and 100%. [24][25][26][27][28][29][30][31] Moreover, of the 20 patients that were initially observed, 70% remained stable over the years or with minimal growth, and only 30% needed further active treatment due to rapid growth or clinically significant symptoms. Other authors have found similar percentage of patients that remain stable throughout the period observation, ranging from 42% to 79%.…”

Section: Discussionmentioning

confidence: 99%

Head and neck paragangliomas: 30‐year experience

2020

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Background We aimed to review our experience and the changing trends in the management of head and neck paragangliomas (HNPG) over the last three decades. Methods We retrospectively reviewed 103 patients with HNPG treated at our center (1986‐2017). We included patients treated with surgery, radiotherapy, and patients maintained under active surveillance. Results Of the surgically treated patients (n = 79), 20% (12/59) of the carotid body tumors (CBT) had a cranial nerve deficit as sequela compared to 95% (19/20) of the non‐CBT. Radiotherapy controlled growth in all tumors treated with this modality (n = 10). Of the initially observed patients, 70% (14/20) remained stable and did not require additional treatment. Stratifying by decades, there was a progressive increase in patients initially attempted to be observed and a decrease in upfront surgery. No deaths attributable to the HNPG were encountered. Conclusions Surgery is an effective treatment for CBT. Nonsurgical treatment should be considered for non‐CBT.

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Section: Discussionmentioning

confidence: 99%

Head and neck paragangliomas: 30‐year experience

2020

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“…However, only sparse standardized Qol data are available in the GJT literature. [51][52][53] Galland-Girodet and colleagues found better scores for hearing and speech, trismus, and overall Qol for patients with head and neck paragangliomas receiving radiotherapy alone vs those receiving radiotherapy and surgery. 51 Patel and colleagues investigated Qol outcomes for primary and secondary GJT patients after GK-based RS.…”

Section: Symptom Control and Quality Of Lifementioning

confidence: 99%

Image‐guided robotic radiosurgery for glomus jugulare tumors—Multicenter experience and review of the literature

Ehret¹,

Kufeld²,

Fürweger

et al. 2020

Head & Neck

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Background: Glomus jugulare tumors (GJTs) are challenging to treat due to their vascularization and location. This analysis evaluates the effectiveness and safety of image-guided robotic radiosurgery (RRS) for GJTs in a multicenter study and reviews the existing radiosurgical literature. Methods: We analyzed outcome data from 101 patients to evaluate local control (LC), changes in pretreatment deficits, and toxicity. Moreover, radiosurgical studies for GJTs have been reviewed. Results: After a median follow-up of 35 months, the overall LC was 99%. Eighty-eight patients were treated with a single dose, 13 received up to 5 fractions. The median tumor volume was 5.6 cc; the median treatment dose for single-session treatments is 16 Gy, and for multisession treatments is 21 Gy. Fifty-six percentage of patients experienced symptom improvement or recovered entirely. Conclusions: RRS is an effective primary and secondary treatment option for GJTs. The available literature suggests that radiosurgery is a treatment option for most GJTs.

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“…The reported high tumour control rates suggest performing stereotactic radiotherapy as a treatment of choice in case of bilateral paragangliomas, where a surgical approach for on neck sides is at high risk of sequelae. In such cases, surgery may be performed for bulky or secreting paragangliomas and on the opposite side, a radiotherapy treatment may be delivered 14 . Alternatively, the neck could bilaterally be treated with fractionated stereotactic radiotherapy 9 .…”

Section: Discussionmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

102

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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The role of radiation therapy in the management of head and neck paragangliomas: Impact of quality of life versus treatment response

Cited by 22 publications

References 35 publications

Head and neck paragangliomas: 30‐year experience

Head and neck paragangliomas: 30‐year experience

Image‐guided robotic radiosurgery for glomus jugulare tumors—Multicenter experience and review of the literature

Surgery of the lateral skull base: a 50-year endeavour

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