Premium
Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas
Author(s) -
Patel Ankur K.,
RodríguezLópez Joshua L.,
Hirsch Barry E.,
Burton Steven A.,
Flickinger John C.,
Clump David A.
Publication year - 2021
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.26497
Subject(s) - radiosurgery , interquartile range , medicine , linear particle accelerator , nuclear medicine , confidence interval , radiography , regimen , radiology , surgery , radiation therapy , beam (structure) , physics , optics
Background Data supporting linear accelerator (linac) stereotactic radiosurgery (SRS) for jugulotympanic paragangliomas (JTPs) come from small series with minimal follow‐up. Herein, we report a large series of JTPs with extended follow‐up after frameless linac‐based SRS. Methods JTPs treated with linac‐based SRS from 2002 to 2019 with 1+ follow‐up image were reviewed for treatment failure (radiographic or clinical progression, or persistent symptoms after SRS requiring intervention) and late toxicities (CTCAE v5.0). Results Forty JTPs were identified; 30 were treated with a multifraction regimen. Median clinical and radiographic follow‐up was 79.7 (interquartile range [IQR] 31.7‐156.9) and 54.4 months (IQR 17.9‐105.1), respectively, with a median 4.5 follow‐up scans (IQR 2‐9). Seven‐year progression‐free survival (PFS) was 97.0% (95% confidence interval 91.1%‐100.0%). PFS was similar between single‐ and multifraction regimens (log rank P = .99). Toxicity was seen in 7.7% (no grade III). Conclusions With extended clinical and radiographic follow‐up, frameless linac‐based SRS provides excellent local control with mild toxicity <8%.