RESUMEN
BACKGROUND: An evaluation of the treatment results for 104 patients with 121 paragangliomas of the temporal bone, carotid body, and/or glomus vagale who were treated with radiation therapy (RT) at the University of Florida between 1968 and 2004. METHODS: Eighty-nine paragangliomas (86%) were treated with conventional megavoltage techniques, 15 (14%) patients with stereotactic fractionated radiation therapy, 6 (6%) patients with stereotactic radiosurgery (SRS), and 11 (11%) patients with intensity-modulated radiation therapy (IMRT). RESULTS: There were 6 local recurrences. One recurrence was salvaged with additional RT. The actuarial local control and cause-specific survival rates at 10 years were 94% and 95%. The overall local control rate for all 121 lesions was 95%; the ultimate local control rate was 96%. The incidence of treatment-related complications was low. CONCLUSION: Fractionated RT offers a high probability of tumor control with minimal risks for patients with paragangliomas of the temporal bone and neck.
Asunto(s)
Neoplasias de Cabeza y Cuello/radioterapia , Recurrencia Local de Neoplasia/radioterapia , Paraganglioma Extraadrenal/radioterapia , Adulto , Anciano , Anciano de 80 o más Años , Cuerpos Aórticos/efectos de la radiación , Cuerpo Carotídeo/efectos de la radiación , Fraccionamiento de la Dosis de Radiación , Femenino , Estudios de Seguimiento , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/prevención & control , Paraganglioma Extraadrenal/mortalidad , Paraganglioma Extraadrenal/patología , Paraganglioma Extraadrenal/cirugía , Radiocirugia/métodos , Planificación de la Radioterapia Asistida por Computador , Radioterapia Adyuvante/métodos , Radioterapia Conformacional/métodos , Radioterapia de Intensidad Modulada/métodos , Estudios Retrospectivos , Análisis de Supervivencia , Hueso Temporal/efectos de la radiación , Resultado del TratamientoRESUMEN
The aim of the study was to present a case of clinically diagnosed glomus vagale in a 42-year-old Aboriginal woman treated with external beam radiotherapy and to carry out a review of the published work. The details of presentation, diagnosis, treatment and follow up of the patient are discussed. A review of the published work was carry out using MEDLINE database with respect to aetiology, clinical presentation, diagnosis, treatment and expected outcomes. Glomus vagale tumours are a subtype of paragangliomas of the head and neck derived from extra-adrenal paraganglia of the autonomic nervous system. They are typically slow-growing, benign masses that are often asymptomatic and rarely show signs of hypersecretion. Treatment options include embolization, surgical excision, radiotherapy or surveillance. Radiotherapy is often used for extensive lesions where surgery is considered prohibitively morbid. Following treatment relapse rates are low with the most patients achieving long-term control. Our patient presented with an extensive lesion compressing the wall of the carotid artery and invading the jugular fossa to involve the clivus. Surgery was offered; however, the patient opted for external beam radiotherapy. A dose of 45 Gy in 25 fractions was delivered with 6-MV photons employing a CT-planned, wedge pair technique. Glomus vagale tumours are rare and should be managed in a multidisciplinary head and neck clinic with both surgical and radiation oncology opinions offered. The toxicities and outcomes of both methods should be discussed.
