J Neurol Surg B Skull Base 2014; 75 - a116
DOI: 10.1055/s-0034-1384020

Treatment of Cervical and Cranial Base Paragangliomas with Conformal Fractionated Radiotherapy: A 25-Year Experience in a Single Institution

Vincent Darrouzet 1, H. E. Thomeer 1, S. Gallan-Girodet 1, J. P. Maire 1
  • 1CHU de Bordeaux, France

Objective: To confirm the benefit of radiotherapy (RT) for patients harboring cervical paraganglioma (PGL) by evaluating the following: overall survival, local control, and quality of life (QoL). Material and Methods: From 1985 to 2010, 130 head and neck PGL were managed. We present a retrospective analysis of a cohort of 30 consecutive patients treated with RT. Survival was used as the primary end point. Local control, volumetric regression, and quality of life were used as secondary end points. QoL was analyzed with EORTC QLQ-C30 and H&N35 questionnaire for 20 patients. A subgroup analysis was performed by two following subgroups: “patients treated with RT alone” and “patients treated with a combined modality of treatment with surgery followed by RT.” Results: Mean follow-up was 7.6 years. Overall 70% of the patients (21/30) were still alive at the time of the analysis. Overall survival and local control were 95 and 96% at 5 years, respectively. Tumor regression after RT was significant 2 and 3 years after treatment (p = 0.018; 0.043). QoL was altered after treatment, the EORTC H&N35 score being worst after combined treatment for speech and hearing (p = 0.004), opening mouth (p = 0.003), and for global symptom (p = 0.01). Conclusion: Optimal treatments of PGL are going to change. RT should be considered as alternative option of treatment, where surgery was previously supposed to be the reference. In that case, QoL will be a major end point of treatment of this benign disease.