{Reference Type}: Journal Article
{Title}: Treatment for paraganglioma with stereotactic radiotherapy.
{Author}: Pontoriero A;Critelli P;Zeppieri M;Angileri FF;Ius T;
{Journal}: World J Clin Cases
{Volume}: 12
{Issue}: 16
{Year}: 2024 Jun 6
{Factor}: 1.534
{DOI}: 10.12998/wjcc.v12.i16.2729
{Abstract}: <B>BACKGROUND: </B>Paragangliomas (PG) are rare neoplasms of neuroendocrine origin that tend to be highly vascularized, slow-growing, and usually sporadic. To date, common treatment options are surgical resection (SR), with or without radiation therapy (RT), and a watch-and-wait approach.<BR><B>OBJECTIVE: </B>To evaluate the local control and effectiveness of exclusive fractionated stereotactic RT (FSRT) treatment in unresectable PG (uPG).<BR><B>METHODS: </B>We retrospectively evaluated patients with uPG (medically inoperable or refused SR) treated with FSRT with a Cyberknife System (Accuray Incorporated, Sunnyvale, California). Toxicity and initial efficacy were evaluated.<BR><B>RESULTS: </B>From May 2009 to January 2023, 6 patients with a median age of 68 (range 20-84) were treated with FSRT. The median delivered dose was 21 Gy (range 20-30 Gy) at a median isodose line of 75.5% (range 70%-76%) in 4 fractions (range 3-5 fractions). The median volume was 13.6 mL (range 12.4-65.24 mL). The median cumulative biological effective dose and equivalent dose in 2-Gy fractions were 70 Gy and 37.10 Gy respectively. Site of origin involved were the timpa-nojugular glomus (4/6), temporal bone, and cervical spine. In 1 of the 6 patients, the follow-up was insufficient; 5 of 6 patients showed a 5-year overall survival and 5-year progression-free survival of 100%. We observed negligible toxicities during and after RT. The majority of patients showed stable symptoms during follow-up. Only 1 patient developed spine metastases.<BR><B>CONCLUSIONS: </B>Our preliminary results on this small cohort of patients suggest that FSRT could be an effective and safe alternative to SR.