Stereotactic radiosurgery in the management of glomus jugulare tumors

Purpose: This retrospective study evaluate the efficacy and toxicity of stereotactic radiosurgery (SRS) in the management of the glomus jugulare tumors. Methods: Fifteen patients were submitted to SRS with a 6MV LINAC at the Hospital Santa Maria in Lisbon between July 1997 and February 2005. Median age was 55.4 years (range 30-77) of twelve females and three males. Six patients have failed to previous treatment modalities. The reasons to manage these patients with SRS included residual or recurrent tumors after surgery and embolization (6), geriartric/medically unsuitable for surgery or unresectable tumors (5) and patient preference (4). The tumor volume ranged from 2.3 to 10.4 ml (mean, 6.3 ml). The median marginal dose was 13.8 Gy (range, 12-15 Gy) and the median maximum dose was 17.6Gy (range, 16.3-18.7Gy). Results: The median time from date of SRS to the last follow-up was 47.3 months (range, 2-92 months) including six and nine patients with more than 60 and 36 months respectively. Improvement of the symptoms and cranial nerve disfunctions were presented in fourteen patients with no melioration in symptoms in one patient who remained with stable tumor. After last surveillance magnetic imaging eleven tumors were shrinkaged and four remained stable being considered as local control achieved in all patients. No acute or late toxicity was detected. Conclusions: Our experience in this series presenting excellent tumor control rate and a favorable toxicity profile support the effectiveness of SRS for patients with glomus jugulare tumors. Copyright (c) 2006 S. Karger AG, Basel.