Artikel
Stereotactic LINAC radiosurgery for glomus jugular tumours: long-term follow-up
Stereotaktische LINAC-Radiochirurgie zur Behandlung von Glomus-Jugulare-Tumoren: Langzeitergebnisse
Suche in Medline nach
Autoren
Veröffentlicht: | 8. Mai 2006 |
---|
Gliederung
Text
Objective: The optimal treatment of glomus jugulare tumours (GJTs) remains controversial. Surgical excision can be associated with a high incidence of cranial nerve injury and decreased quality of life. We present long-term results of LINAC radiosurgery (LINAC-RS) in the management of GJTs.
Methods: From May 1991 through September 2005, 22 GJTs patients (F:M = 18:4, age 29-80 years, median 60 years) were treated with stereotactic LINAC-RS for ongoing growth of either primary tumour or of the residual tumour following surgery. Thirteen of 22 patients with a median follow-up of 7.4 years (range: 5-12 years), were selected for retrospective analysis. A median single dose of 15 Gy (range 11-20 Gy) was applied to the surface of the tumour.
Results: Following LINAC-RS, 9 of the 13 patients (69%) had been improved clinically, 4 (31%) unchanged. Accessible neurological signs improved in 3 (23%) and remained stable in 9 (69%). One patient developed moderate facial nerve palsy (H&B II). MR examinations showed tumour shrinkage in 9 (69%) and no further progression in 4 patients (31%).
Conclusions: This study shows that stereotactic LINAC-RS for GJTs management is safe and highly effective providing long-term tumour control. Thus, radiosurgery is a promising new modality in the management of patients with GJTs and should be included in the discussion of treatment options.
For a good outcome an optimum dose conformation is obligatory, especially for intracranial tumour compartments. The use of a computerized µMLC for LINAC-RS has been encouraging. We expect that computerized µMLC will enable us to treat patients with larger tumours and to reduce radiation-induced side effects by minimizing the radiation exposure to adjacent healthy brain tissue and critical structures.