Head and Neck Paragangliomas Radiosurgery: Long-Term, Single-Institution Experience

Objective: Paragangliomas are highly vascular and predominantly benign neoplasms that have traditionally been treated by surgery, embolization and/or external beam radiotherapy (EBRT). The aim of this study is to evaluate the long-term local tumor control and safety of radiosurgery.

Patients and Methods: In the period between August 2004 and May 2014, 27 patients underwent radiosurgery due to a paraganglioma of the head and neck. Twenty-one out of these 27 patients have a minimum clinical and radiological (MRI) follow-up of 12 months and they have been included in the present analysis. All patients were treated by radiosurgery. All patients were clinically and radiologically evaluated before and after the treatment.

Results: Seven lesions underwent a single-session radiosurgery (sRS) with a mean dose of 12.2 Gy (range: 11–13 Gy). Fourteen lesions had a multisession radiosurgery (mRS) with a mean dose of 24.7 Gy (range: 20–30 Gy) delivered in 3 to 5 fractions. The reference isodose ranged from 72 and 84%. The mean tumor volume for sRS was 4 cc (range: 1.4–9.2). The mean volume for mRS was 19cc (range 1.3–50.9). The mean follow-up is 46 months (range: 11–111). After this period, all lesions are radiologically stable or show a partial response. Neurological conditions are generally maintained or improved.

Conclusion: Both single and multisession radiosurgery have been confirmed as a safe and effective treatment modality for paragangliomas of the head and neck.