Radiotherapy for benign head and neck paragangliomas

Purpose To update our experience treating benign head‐and‐neck paragangliomas (PGs) with radiotherapy (RT). Methods A total of 149 patients with 176 PGs received curative‐intent RT; 126 received RT to 1 PG and 23 to 2 or more PGs. The most common dose fractionation schedule was 45 Gy/25 once‐daily fractions/5 weeks which was used to treat 147 PGs (83.5%) in 123 patients (82.6%). Patients were followed with physical examination and CT/MRI. The median follow‐up for all patients was 10.6 years (range, 0.2‐50.4 years); the median follow‐up for surviving patients was 11.1 years (range, 0.2‐50.4). Results The 5‐year, 10‐year, and 15‐year outcomes were: local control, 99%, 96%, and 95%; distant metastasis‐free survival, 99%, 99%, and 99%; cause‐specific survival, 98%, 98%, and 98%; and overall survival, 90%, 75%, and 64%, respectively. No patient developed a moderate or severe complication, or a radiation‐induced second tumor or malignant transformation of the benign PG. Conclusion RT is an effective treatment for head‐and‐neck PGs with a low risk of complications.