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J Neurol Surg B Skull Base 2017; 78(03): 251-255
DOI: 10.1055/s-0036-1597986
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Comparative Neurologic Outcomes of Salvage and Definitive Gamma Knife Radiosurgery for Glomus Jugulare: A 20-Year Experience

Daniel V. Wakefield
1   Department of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Garrett T. Venable
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
,
Noam A. VanderWalde
1   Department of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
3   West Cancer Center, Memphis, Tennessee, United States
,
L. Madison Michael II
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
4   Semmes-Murphey Clinic, Memphis, Tennessee, United States
5   Memphis Regional Gamma Knife Center, Memphis, Tennessee, United States
,
Jeffery M. Sorenson
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
4   Semmes-Murphey Clinic, Memphis, Tennessee, United States
5   Memphis Regional Gamma Knife Center, Memphis, Tennessee, United States
,
Jon H. Robertson
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
4   Semmes-Murphey Clinic, Memphis, Tennessee, United States
5   Memphis Regional Gamma Knife Center, Memphis, Tennessee, United States
,
David Cunninghan
2   Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, Tennessee, United States
4   Semmes-Murphey Clinic, Memphis, Tennessee, United States
5   Memphis Regional Gamma Knife Center, Memphis, Tennessee, United States
,
Matthew T. Ballo
1   Department of Radiation Oncology, University of Tennessee Health Science Center, Memphis, Tennessee, United States
3   West Cancer Center, Memphis, Tennessee, United States
› Author Affiliations
Further Information

Publication History

14 October 2016

04 December 2016

Publication Date:
23 January 2017 (online)

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Abstract

Objective This case series investigates management of glomus jugulare (GJ) tumors utilizing definitive and salvage Gamma Knife stereotactic radiosurgery (GKSRS).

Methods A retrospective chart review was performed to collect data. Statistical analysis included patient, tumor, and treatment information.

Results From 1996 to 2013, 17 patients with GJ received GKSRS. Median age was 64 years (range, 27–76). GKSRS was delivered for definitive treatment in eight (47%) and salvage in nine (53%) patients. Median tumor volume was 9.8 cm3 (range, 2.8–42 cm3). Median dose was 15 Gy (range, 13–18 Gy). Median follow-up was 123 months (range, 38–238 months). Tumor size decreased in 10 (59%), stabilized in 6 (35%), and increased in 1 patient (6%). Overall neurological deficit improved in 53%, stabilized in 41%, and worsened in 6% of patients. Overall cause-specific survival was 100%, and actuarial local control was 94%. Eighty-eight percent of patients without prior resection experienced neurologic deficit improvement, while 25% of patients with prior resection experienced neurologic improvement (p = 0.02).

Conclusion Gamma Knife radiosurgery provides effective long-term control of GJ and overall improvement or stabilization of neurological deficit in most patients. Patients with prior resection are less likely to experience improvement of neurologic deficit.

Keywords

glomus jugulare - Gamma Knife - radiosurgery - salvage
 

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