RT-37 * LONG TERM RESULTS OF GAMMA KNIFE RADIOSURGERY FOR GLOMUS TUMORS

Abstract

INTRODUCTION: Paragangliomas (PGs) or glomus tumors are rare, vascular tumors that arise from chief cells in the paraganglia. Traditionally, standard treatment for these tumors includes microsurgical resection and conventional radiotherapy. Seven of the patients treated had previously undergone at least one microsurgical resection. Three underwent one surgery, one underwent two surgeries, one underwent three surgeries, one underwent one surgery and radiotherapy, and one underwent one surgery, radiotherapy, and a Gamma Knife procedure. Before the treatment, only one patient lacked cranial nerve deficit, while the others had at least one. We sought to analyze our data of PGs treated with Gamma Knife Radiosurgery. METHODS: We retrospectively examined the outcomes of 24 PGs in 24 patients treated with Gamma Knife Radiosurgery at the Miami Neuroscience Center. We collected data from medical records, imaging studies, and follow-up appointments. RESULTS: Patients were treated from 1993 to 2014. 87.5% (21) of the patients were female and 12.5% (3) were male. Volume of tumors ranged from 2.8 cc to 40.0 cc, with a mean of 14.7 cc. Doses to the tumors ranged from 10 to 20 cGy, with a mean of 12.8 cGy. One patient received staged treatment six months apart from each other, while every other patient received only one dose of treatment. Tumor control rates were 100%, with long term follow-ups ranging from 3 months to 240 months. No patients experienced additional cranial nerve deficit; in 3 patients there was significant improvement. CONCLUSION: We believe that Gamma Knife Radiosurgery is the optimal treatment for new and recurrent PGs. A common criticism of Gamma Knife Radiosurgery is the lack of long term results. However, with a sample size of 24 patients, median follow-ups of 65 months, and a 100% control rate to date, we believe that Gamma Knife is the best available treatment for paragangliomas.