Abstract | OBJECTIVE: To define the role of wait-and-scan and radiotherapy (RT) in the treatment of temporal bone paragangliomas and to review the literature on the outcomes of RT as a treatment modality. MATERIALS AND METHODS: This was a retrospective and literature review. The records of 381 patients with 382 tumors between 1988 and 2012 were analyzed. Patients who were subjected to initial wait-and-scan or primary RT were analyzed for tumor response, facial, and lower cranial nerve status on follow-up (FU). RESULTS AND OBSERVATIONS: None of the 145 patients (38%) with Class A and B tumors were subjected to wait-and-scan or RT and all were operated on. Of the 237 patients (62%) with Class C and D tumors, 47 (19.8%) were subjected to an initial wait-and-scan policy and 1 (0.4%) underwent primary RT. In 24 patients subjected to wait-and-scan with a FU of less than 3 years, tumor remained stable in 22 patients (92%). In 12 patients with a FU between 3 and 5 years, the tumor remained stable or regressed in 10 patients (83%). In 11 patients with a FU of more than 5 years, the tumor remained stable or regressed in 5 patients (45%). A literature review of the results of RT did not conclusively prove that it was effective as a primary modality of treatment for temporal bone paragangliomas. CONCLUSION: In elderly patients with advanced tumors, a wait-and-scan approach is recommended, and RT is initiated only when fast-growing tumors are detected. There is insufficient evidence in literature to suggest that RT could be an effective alternative to surgery in Class C and D tumors.
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Authors | Sampath Chandra Prasad, Hassen Ait Mimoune, Flavia D'Orazio, Marimar Medina, Andrea Bacciu, Renato Mariani-Costantini, Paolo Piazza, Mario Sanna |
Journal | Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
(Otol Neurotol)
Vol. 35
Issue 5
Pg. 922-31
(Jun 2014)
ISSN: 1537-4505 [Electronic] United States |
PMID | 24751735
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Female
- Humans
- Male
- Middle Aged
- Paraganglioma
(pathology, radiotherapy)
- Retrospective Studies
- Skull Neoplasms
(pathology, radiotherapy)
- Temporal Bone
(pathology)
- Treatment Outcome
- Watchful Waiting
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