Artikel
LANAC-radiosurgery for the treatment of glomus jugulare tumors: Long-term follow-up
Stereotaktische LINAC-Radiochirurgie zur Behandlung von Glomus Jugulare Tumoren: Langzeit-Ergebnisse
Suche in Medline nach
Autoren
Veröffentlicht: | 30. Mai 2008 |
---|
Gliederung
Text
Objective: To evaluate the long-term efficacy of single-fraction stereotactic LINAC-Radiosurgery (LINAC-RS) for the treatment of glomus jugulare tumors (GJTs).
Methods: Between May 1991 and June 2007, 25 consecutive patients (f:m = 20:5, median age: 60 years, range: 28.7 to 80 years) suffering from GJTs underwent LINAC-RS at our institution. Eleven patients underwent surgical resection, eight patients embolization and one patient received fractionated irradiation (total dose: 64 Gy) prior to LINAC-RS. The most common symptoms were pulsatile tinnitus (n=14), hyp-/anacusis (n=18), vertigo/dizziness (n=6) and weakness of cranial nerves V, VII, IX-XIII (n=21). A median therapeutic dose of 15 Gy (range: 11 to 20 Gy) was applied to the tumor surface. The median isodose was 70% (range 44 to 80%) and the median number of isocenters was 4 (range 1 to 7). 11 patients have undergone LINAC-RS using a Micro-Multi-Leaf Collimator since 2002. The median tumor volume was 10.8 cm3 (range: 4.4 - 51 cm3).
Results: After a median follow-up of 88 months (range: 4.6 to 197.6 months, 10 patients with a follow-up >10 years) 17 patients had an improvement in their neurological status. One patient developed a permanent paresis of the facial nerve (House & Brackmann grade II). Two patients died, one due to old age and one due to sepsis after hip surgery. Follow-up MR images show a regression in tumor size in 12 patients and a stable state in 13 patients.
Conclusions: Stereotactic LINAC-Radiosurgery provides a long-term treatment method for GJTs. The treatment-related morbidity is very low.