2703 - Radiation Therapy for Head and Neck Paragangliomas: Tumor Regression Trends and Overall Outcomes of Surgical and Radiation Approaches
Presenter(s)
R. Aljudibi1, D. A. Alghamdi2, S. Aldhahri3, H. A. S. Alhussain1, O. Alfaqih4, K. Alqahtani3, H. Alassaf1, M. Aldohan1, A. Iqbal5, S. Almohsen5, M. Mousili5, R. Elgendy5, and Y. Bayoumi1; 1Department of Radiation Oncology, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia, 2King Fahad Medical City, Medical Laboratory Department , Pathology Department., Riyadh, Saudi Arabia, 3Head and Neck Surgical Oncology Department, King Fahad Medical City, Riyadh, Saudi Arabia, 4Department of Pathology. King Fahad Medical City, Riyadh, Saudi Arabia, 5Medical Physics Department, Comprehensive Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
Purpose/Objective(s): Given the complexity of managing head and neck paragangliomas (HNPG), this study aims to investigate different treatment modalities outcomes, and tumor regression rates in patients treated with radical radiotherapy (RT).
Materials/Methods: This retrospective study reviewed patients with unusual HNPG treated from 2011 to 2023. We compared outcomes of surgical resection and RT, measuring five-year progression-free survival (5-year PFS) from treatment to first failure. Tumor volumes were contoured using a treatment planning system on annual magnetic resonance imaging (MRI) scans, which were reviewed by expert radiation oncologists.
Results: This study involved 43 patients (mean age 49, 65% female) with hearing loss as the most common initial symptom. The mean tumor volume was 11.87 cm³, primarily located in glomus jugulare (58.1%) and jugulotympanicum (20.9%). Treatment included RT (41.9%), surgery (48.8%), and observation (9.3%). 5-year PFS rates were significantly higher for radiation therapy (91±9%) compared to surgery (53±15%) p=0.001. Among those who progressed, six post-surgery patients were salvaged successfully with radiation. Tumor volume regression rates for radiation therapy were 23%, 35%, 42%, 44%, and 64% over five years. Surgical complications were more frequent, while radiation therapy had a lower complication rate.
Conclusion: Surgery exhibits inferior PFS compared to RT. While complete surgical resection may provide a potential cure, RT is a safer option with a lower risk of complications and better PFS. Caution is warranted in interpreting these findings.