Introduction: The aim of this study was to evaluate the long term clinical and radiological outcome in patients undergoing Gamma Knife radiosurgery (GKRS) for glomus jugulare tumors.
Methods: Forty-two patients with forty-three glomus jugulare lesions were treated using Gamma Knife radiosurgery (GKRS) at Cleveland Clinic from 1997-2016. Clinical, imaging and radiosurgery data were collected from an IRB-approved database. Tumor volumetric analysis was performed following GKRS.
Results: Most patients were females (n=35, 83.3%) and median age was 61 years (range 23-88 years). Median tumor volume and diameter was 5 cc (0.4cc-28.2cc) and 3 cm (0.8cm- 5.9 cm), respectively, with a median follow-up of 62.3 months (3.4 -218.6 months). Tinnitus (78.6%) was the most frequent presenting complaint followed by hearing loss (69.0%). Overall, twenty patients (47.6%) improved clinically, eight (19.04%) worsened, and fourteen (33.3%) remained unchanged at last follow-up. New onset or worsening of hearing loss was noted in 6 patients (14.3%) after GKRS. The median prescription dose to the tumor margin was 15 Gy (12-18 Gy). Overall, median reduction in tumor volume and maximum tumor diameter at last follow-up was 33.3% and 11.54% respectively. At last follow-up MRI, decrease in tumor volume was seen in 31 lesions (81.6%), increase in 6 lesions (15.8%) and no change in tumor volume in one lesion (2.6%). The 5- and 10-year tumor control rate was 87% ± 6% and 69% ± 13%, respectively. There was no correlation between maximum or mean dose to the IAC and post-GK hearing loss (p=0.50 and 0.73, respectively).
Conclusions: GKRS is safe and effective in patients with glomus jugulare tumors and results in durable long-term control. GKRS outweighs the morbidity associated with surgical resection, particularly lower cranial nerve dysfunction and can be a first-line management option in these patients.
Patient Care: Our study adds to the literature regarding the long term control rate of GKRS in patients with gloms tumors.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Describe the long-term control rate following GKRS for glomus tumors.
2) Impact of GKRS on clinical symptoms related to glomus tumors during the follow up.