Long-Term Outcome Following Stereotactic Radiosurgery for Glomus Jugulare Tumors

Neurosurgery 83:1007–1014, 2018

Glomus jugulare tumors (GJTs) are rare benign tumors, which pose significant treatment challenges due to proximity to critical structures.

OBJECTIVE: To evaluate the long-term clinical and radiological outcomein patients undergoing stereotactic radiosurgery (SRS) for GJTs through retrospective study.

METHODS: Forty-two patientswith 43 GJTswere treated using Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) at our institute from 1997 to 2016. Clinical, imaging, and radiosurgery data were collected from an institutional review board approved database.

RESULTS: Most patients were females (n = 35, 83.3%) and median age was 61 yr (range 23- 88 yr).Median tumor volume and diameterwere 5 cc and 3 cm, respectively,with a median follow-up of 62.3 mo (3.4-218.6 mo). Overall, 20 patients (47.6%) improved clinically and 14 (33.3%) remained unchanged at last follow-up. New onset or worsening of hearing loss was noted in 6 patients (17.2%) after SRS. The median prescription dose to the tumor margin was 15 Gy (12-18 Gy). Median reduction in tumor volume and maximum tumor diameter at last follow-up was 33.3% and 11.54%, respectively. The 5-yr and 10-yr tumor control rates were 87%±6% and 69%±13%, respectively. There was no correlation between maximum or mean dose to the internal acoustic canal and post-GK hearing loss (P > .05).

CONCLUSION: SRS is safe and effective in patients with GJTs and results in durable, longterm control. SRS has lower morbidity than that associated with surgical resection, particularly lower cranial nerve dysfunction, and can be a first-line management option in these patients.