Results of a Systematic Literature Study on the Feasibility of Treatment Modalities for Glomus Caroticum and Temporale Tumors of Different Tumor Class

Objective: To evaluate the feasibility of surgery and radiotherapy (RT) as treatment for glomus caroticum (GCT) and glomustemporale tumors (GTT) of different Shamblin and Fisch classes, respectively. Study Design: Systematic literature review. Material and Methods: PubMed was searched using terms for paraganglioma, surgery, and (stereotactic) RT. We screened 3,505 articles and 42 were selected. Per tumor class we gathered information on local control rate, induced cranial nerve damage (ICND), and life-threatening complications. Results: We evaluated 140 Shamblin class 1, 156 class 2, and 150 class 3 GCT treated with surgery. No data on the effects of RT was found per Shamblin class. Local control decreased with increasing tumor class (92-82%), and ICND and complications increased with class from 16 to 39 and 0 to 12%, respectively. With respect to GTT, we evaluated 56 Fisch class A, 40 class B, 111 class C, and 123 class D GTT treated with surgery. Local control decreased with increasing Fisch class from 100 to 72%, ICND increased from 0 to 149%, and complications from 0 to 26%. Compared with surgery, Fisch class C and D GTT treated with RT (n = 68 and 65, respectively) showed significantly higher local control (94, 84%, respectively), and lower ICND (4,9% respectively) and complication rates (1% both classes). Conclusion: Surgery of higher class tumors is associated with less local control and high morbidity. In Fisch class C and D GTT, RT is associated with lesser morbidity, and higher control rates compared with surgery.