Premium
Paragangliomas: Presentation and management by radiotherapy at the P rince of W ales H ospital
Author(s) -
Smee Robert I,
Jayasekara Jayana,
Williams Janet R,
Hanna Claire
Publication year - 2015
Publication title -
journal of medical imaging and radiation oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.31
H-Index - 43
eISSN - 1754-9485
pISSN - 1754-9477
DOI - 10.1111/1754-9485.12226
Subject(s) - medicine , radiation therapy , surgery , complication , population , retrospective cohort study , tinnitus , presentation (obstetrics) , paraganglioma , environmental health , psychiatry
Paragangliomas are commonly treated with surgery, while radiotherapy is reserved for those that are inoperable or have relapsed. However, this retrospective study aims to determine whether radiotherapy is a viable initial treatment for paragangliomas. Methods Of 73 tumours researched, 44 were diagnosed and treated from J anuary 1967 to D ecember 2012 at the R adiation O ncology D epartment at the P rince of W ales H ospital and thus were eligible for analysis. Median follow‐up time was 3.5 years with a range of 1 to 40 years. Thirty‐four tumours were treated with radiotherapy only, and 10 tumours were treated with both surgical resection and radiotherapy. Local control and cause‐specific survival were the primary end points measured. Results Five‐year local control rate for the population of 44 lesions was 89%; it was 100% in the group treated by radiotherapy alone, but only 50% in the group treated by surgery followed by radiotherapy, with radiation used for salvage. The difference in control rates between these two subset groups was found to be statistically significant ( P < 0.001). Cause‐specific survival rates for this eligible population at 5 and 10 years were 98% and 90%, respectively. After initial radiotherapy, 4 patients had improved cranial nerve function, there was clinical improvement in tinnitus, and one new cranial nerve deficit developed where a high dose was used. Conclusions Radiotherapy has high local control rates and few complications. The local control and complication rates compare favourably to surgery.