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Michael Lim - One of the best experts on this subject based on the ideXlab platform.
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radiosurgery of Glomus Jugulare tumors a meta analysis
International Journal of Radiation Oncology Biology Physics, 2010Co-Authors: Z D Guss, Sachin Batra, Charles J Limb, Michael E Sughrue, Kristin J Redmond, Daniele Rigamonti, Andrew T Parsa, Steven D Chang, Lawrence Kleinberg, Michael LimAbstract:Purpose During the past two decades, radiosurgery has arisen as a promising approach to the management of Glomus Jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of Glomus Jugulare tumors. Methods and Materials To identify eligible studies, systematic searches of all Glomus Jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 Glomus Jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was Results Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions The present study reports the results of a meta-analysis for the radiosurgical management of Glomus Jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of Glomus Jugulare tumors.
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radiosurgery for Glomus Jugulare history and recent progress
Neurosurgical Focus, 2009Co-Authors: Z D Guss, Sachin Batra, Daniele Rigamonti, Andrew T Parsa, Steven D Chang, Lawrence Kleinberg, Michael LimAbstract:In this article the authors review the literature for recent studies of radiosurgical treatment for Glomus Jugulare. These studies demonstrate that radiosurgery results in similar Glomus Jugulare tumor control and a superior morbidity profile compared with surgical treatment. In addition, patients treated with radiosurgery usually remain stable clinically or improve. Given the indolent nature of these tumors, however, more follow-up is required to ensure that the immediate benefits are lasting. These preliminary reports demonstrate that the use of radiosurgery as a primary treatment for Glomus Jugulare should be extended to encompass more of the patients who are currently assigned to microsurgical treatment.
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irradiation of Glomus Jugulare tumors a historical perspective
Neurosurgical Focus, 2007Co-Authors: Steven D Chang, John R Adler, Michael LimAbstract:✓ Glomus Jugulare tumors are rare, slow-growing vascular lesions that arise from the chief cells of the paraganglia within the jugular bulb. They can be associated with the tympanic branch of the glossopharyngeal nerve (Jacobsen nerve) or the auricular branch of the vagus nerve (Arnold nerve) and are also referred to as chemodectomas or nonchromaffin paragangliomas. Optimal treatment of these histologically benign tumors remains controversial. Surgery remains the treatment of choice, but can carry high morbidity rates. External-beam radiation was originally used for subtotal resections and in patients who were poor surgical candidates; however, radiosurgery has recently been introduced as an effective and safe treatment option for patients with these tumors. In this article the authors discuss the history of radiation therapy for Glomus Jugulare tumors, focusing on recent radiosurgical results.
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radiosurgery for Glomus Jugulare tumors
Technology in Cancer Research & Treatment, 2007Co-Authors: Michael Lim, Regina S Bower, Jasvinder Singh Nangiana, John R Adler, Steven D ChangAbstract:Results for treating Glomus Jugulare tumors with radiosurgery have been limited by short follow-up and small number of patients. We report our experience using LINAC or CyberKnife in 21 tumors with a median follow-up of 66 months (Mean follow-up of 60 months). In addition, we have a subset of eight patients that were followed out for more than 10 years. Patients were treated with doses ranging from 1400 cGy to 2700 cGy. We retrospectively assessed patients for efficacy and post treatment side effects. All patients had stable neurological symptoms, and two patients experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this patient received previous external beam radiotherapy. All tumors remained stable or decreased in size by MRI exam. Our results support radiosurgery as an effective and safe method of treatment for Glomus Jugulare tumors with low morbidity as evidenced by a larger number of patients and long term follow-up.
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efficacy and safety of stereotactic radiosurgery for Glomus Jugulare tumors
Neurosurgical Focus, 2004Co-Authors: Michael Lim, John R Adler, Iris C Gibbs, Steven D ChangAbstract:Object. Since the mid-1990s the use of radiosurgery for Glomus Jugulare tumors has grown in popularity. Despite its increased use, follow-up periods for radiosurgery are short and the numbers of patients reported are small. To add to the available information, the authors report their experience with the application of linear accelerator (LINAC) or CyberKnife modalities in 13 patients with 16 tumors. Methods. All patients were treated with frame-based LINAC or CyberKnife radiosurgery, with doses ranging from 1400 to 2700 cGy. Patients were retrospectively assessed for posttreatment side effects, which included hearing loss, tongue weakness, and vocal hoarseness. The patients’ most recent magnetic resonance (MR) images were also assessed for changes in tumor size. The median follow-up duration was 41 months and the mean follow-up period was 60 months. All tumors remained stable or decreased in size on follow-up MR images. All patients had stable neurological symptoms, and one experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this individual had received previous external-beam radiation therapy. Conclusions. The authors’ findings continue to support radiosurgery as an effective and safe method of treatment for Glomus Jugulare tumors that results in low rates of morbidity.
Bruce E Pollock - One of the best experts on this subject based on the ideXlab platform.
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stereotactic radiosurgery in the management of vestibular schwannoma and Glomus Jugulare indications techniques and results
Otolaryngologic Clinics of North America, 2015Co-Authors: Jeffrey T Jacob, Bruce E Pollock, Matthew L Carlson, Colin L W Driscoll, Michael J LinkAbstract:Gamma Knife stereotactic radiosurgery (GKS) has become an important management strategy for an increasing number of patients with skull base tumors. For select patients with lateral skull base disorders, given the proximity to sensitive critical structures such as the brainstem, cranial nerves, and cochlea, this technology has emerged as a first-line treatment to achieve the paramount goals of long-term tumor control and maintenance of existing neurologic function. This article reviews the indications, technique, and results of GKS for the treatment of vestibular schwannoma and Glomus Jugulare tumors, and highlights our experience in treating these tumors at the Mayo Clinic.
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stereotactic radiosurgery in patients with Glomus Jugulare tumors
Neurosurgical Focus, 2004Co-Authors: Bruce E PollockAbstract:Object. Microsurgical removal of Glomus Jugulare tumors is frequently associated with injury of the lower cranial nerves. To decrease the morbidity associated with tumor management in these patients, gamma knife surgery (GKS) was performed as an alternative to resection. Methods. Between 1990 and 2003, 42 patients underwent GKS as the primary management (19 patients) or for recurrent Glomus Jugulare tumors (23 patients). Facial weakness and deafness were more common in patients with recurrent tumors than in those in whom primary GKS was performed (48% compared with 11%, p = 0.02). The mean tumor volume was 13.2 cm 3 ; the mean tumor margin dose was 14.9 Gy. The mean follow-up period for the 39 patients in whom evaluation was possible was 44 months (range 6–149 months). After GKS, 12 tumors (31%) decreased in size, 26 (67%) were unchanged, and one (2%) grew. The patient whose tumor grew underwent repeated GKS. Progression-free survival after GKS was 100% at 3 and 7 years, and 75% at 10 years. Six patients (15%) experienced new deficits (hearing loss alone in three, facial numbness and hearing loss in one, vocal cord paralysis and hearing loss in one, and temporary imbalance and/or vertigo in one). In 26 patients in whom hearing could be tested before GKS, hearing preservation was achieved in 86 and 81% at 1 and 4 years posttreatment, respectively. No patient suffered a new lower cranial nerve deficit after one GKS session; the patient in whom repeated GKS was performed experienced a new vocal cord paralysis 1 year after his second procedure. Conclusions. Gamma knife surgery provided tumor control with a low risk of new cranial nerve injury in early follow-up review. This procedure can be safely used as a primary management tool in patients with Glomus Jugulare tumors that do not have significant cervical extension, or in patients with recurrent tumors in this location.
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Glomus Jugulare tumor tumor control and complications after stereotactic radiosurgery
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2002Co-Authors: Robert L. Foote, Deborah A. Gorman, Paula J. Schomberg, Robert W. Kline, Bruce E Pollock, Scott L Stafford, Michael J Link, Scott E Strome, Jan L Kasperbauer, Kerry D OlsenAbstract:Background We evaluated toxicity and long-term efficacy of stereotactic radiosurgery in patients with symptomatic or progressive Glomus Jugulare tumors. Methods Twenty-five consecutive patients (age, 30–88 years; 17 women, 8 men) who underwent stereotactic radiosurgery with the Leksell Gamma Knife (dose, 12–18 Gy) were prospectively followed. MRI and clinical examinations were performed at 6 months and 1, 2, and 3 years, and then every 2 years. Results None of the tumors increased in size, 17 were stable, and 8 decreased (median imaging follow-up, 35 months; range, 10–113 months). Symptoms subsided in 15 patients (60%); vertigo occurred in 1, but balance improved with vestibular training (median clinical follow-up, 37 months; range, 11–118 months). No other new or progressive neuropathy of cranial nerves V–XII developed. Conclusions Stereotactic radiosurgery can achieve excellent tumor control with low risk of morbidity in the treatment of Glomus Jugulare tumors. The lower cranial nerves can safely tolerate a radiosurgical dose of 12 to 18 Gy. © 2002 Wiley Periodicals, Inc. Head Neck 24: 332–339, 2002; DOI 10.1002/hed.10005
Steven D Chang - One of the best experts on this subject based on the ideXlab platform.
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radiosurgery of Glomus Jugulare tumors a meta analysis
International Journal of Radiation Oncology Biology Physics, 2010Co-Authors: Z D Guss, Sachin Batra, Charles J Limb, Michael E Sughrue, Kristin J Redmond, Daniele Rigamonti, Andrew T Parsa, Steven D Chang, Lawrence Kleinberg, Michael LimAbstract:Purpose During the past two decades, radiosurgery has arisen as a promising approach to the management of Glomus Jugulare. In the present study, we report on a systematic review and meta-analysis of the available published data on the radiosurgical management of Glomus Jugulare tumors. Methods and Materials To identify eligible studies, systematic searches of all Glomus Jugulare tumors treated with radiosurgery were conducted in major scientific publication databases. The data search yielded 19 studies, which were included in the meta-analysis. The data from 335 Glomus Jugulare patients were extracted. The fixed effects pooled proportions were calculated from the data when Cochrane's statistic was statistically insignificant and the inconsistency among studies was Results Across all studies, 97% of patients achieved tumor control, and 95% of patients achieved clinical control. Eight studies reported a mean or median follow-up time of >36 months. In these studies, 95% of patients achieved clinical control and 96% achieved tumor control. The gamma knife, linear accelerator, and CyberKnife technologies all exhibited high rates of tumor and clinical control. Conclusions The present study reports the results of a meta-analysis for the radiosurgical management of Glomus Jugulare. Because of its high effectiveness, we suggest considering radiosurgery for the primary management of Glomus Jugulare tumors.
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radiosurgery for Glomus Jugulare history and recent progress
Neurosurgical Focus, 2009Co-Authors: Z D Guss, Sachin Batra, Daniele Rigamonti, Andrew T Parsa, Steven D Chang, Lawrence Kleinberg, Michael LimAbstract:In this article the authors review the literature for recent studies of radiosurgical treatment for Glomus Jugulare. These studies demonstrate that radiosurgery results in similar Glomus Jugulare tumor control and a superior morbidity profile compared with surgical treatment. In addition, patients treated with radiosurgery usually remain stable clinically or improve. Given the indolent nature of these tumors, however, more follow-up is required to ensure that the immediate benefits are lasting. These preliminary reports demonstrate that the use of radiosurgery as a primary treatment for Glomus Jugulare should be extended to encompass more of the patients who are currently assigned to microsurgical treatment.
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irradiation of Glomus Jugulare tumors a historical perspective
Neurosurgical Focus, 2007Co-Authors: Steven D Chang, John R Adler, Michael LimAbstract:✓ Glomus Jugulare tumors are rare, slow-growing vascular lesions that arise from the chief cells of the paraganglia within the jugular bulb. They can be associated with the tympanic branch of the glossopharyngeal nerve (Jacobsen nerve) or the auricular branch of the vagus nerve (Arnold nerve) and are also referred to as chemodectomas or nonchromaffin paragangliomas. Optimal treatment of these histologically benign tumors remains controversial. Surgery remains the treatment of choice, but can carry high morbidity rates. External-beam radiation was originally used for subtotal resections and in patients who were poor surgical candidates; however, radiosurgery has recently been introduced as an effective and safe treatment option for patients with these tumors. In this article the authors discuss the history of radiation therapy for Glomus Jugulare tumors, focusing on recent radiosurgical results.
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radiosurgery for Glomus Jugulare tumors
Technology in Cancer Research & Treatment, 2007Co-Authors: Michael Lim, Regina S Bower, Jasvinder Singh Nangiana, John R Adler, Steven D ChangAbstract:Results for treating Glomus Jugulare tumors with radiosurgery have been limited by short follow-up and small number of patients. We report our experience using LINAC or CyberKnife in 21 tumors with a median follow-up of 66 months (Mean follow-up of 60 months). In addition, we have a subset of eight patients that were followed out for more than 10 years. Patients were treated with doses ranging from 1400 cGy to 2700 cGy. We retrospectively assessed patients for efficacy and post treatment side effects. All patients had stable neurological symptoms, and two patients experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this patient received previous external beam radiotherapy. All tumors remained stable or decreased in size by MRI exam. Our results support radiosurgery as an effective and safe method of treatment for Glomus Jugulare tumors with low morbidity as evidenced by a larger number of patients and long term follow-up.
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efficacy and safety of stereotactic radiosurgery for Glomus Jugulare tumors
Neurosurgical Focus, 2004Co-Authors: Michael Lim, John R Adler, Iris C Gibbs, Steven D ChangAbstract:Object. Since the mid-1990s the use of radiosurgery for Glomus Jugulare tumors has grown in popularity. Despite its increased use, follow-up periods for radiosurgery are short and the numbers of patients reported are small. To add to the available information, the authors report their experience with the application of linear accelerator (LINAC) or CyberKnife modalities in 13 patients with 16 tumors. Methods. All patients were treated with frame-based LINAC or CyberKnife radiosurgery, with doses ranging from 1400 to 2700 cGy. Patients were retrospectively assessed for posttreatment side effects, which included hearing loss, tongue weakness, and vocal hoarseness. The patients’ most recent magnetic resonance (MR) images were also assessed for changes in tumor size. The median follow-up duration was 41 months and the mean follow-up period was 60 months. All tumors remained stable or decreased in size on follow-up MR images. All patients had stable neurological symptoms, and one experienced transient ipsilateral tongue weakness and hearing loss, both of which subsequently resolved. One patient experienced transient ipsilateral vocal cord paresis; however, this individual had received previous external-beam radiation therapy. Conclusions. The authors’ findings continue to support radiosurgery as an effective and safe method of treatment for Glomus Jugulare tumors that results in low rates of morbidity.
Robert L. Foote - One of the best experts on this subject based on the ideXlab platform.
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Glomus Jugulare tumor tumor control and complications after stereotactic radiosurgery
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2002Co-Authors: Robert L. Foote, Deborah A. Gorman, Paula J. Schomberg, Robert W. Kline, Bruce E Pollock, Scott L Stafford, Michael J Link, Scott E Strome, Jan L Kasperbauer, Kerry D OlsenAbstract:Background We evaluated toxicity and long-term efficacy of stereotactic radiosurgery in patients with symptomatic or progressive Glomus Jugulare tumors. Methods Twenty-five consecutive patients (age, 30–88 years; 17 women, 8 men) who underwent stereotactic radiosurgery with the Leksell Gamma Knife (dose, 12–18 Gy) were prospectively followed. MRI and clinical examinations were performed at 6 months and 1, 2, and 3 years, and then every 2 years. Results None of the tumors increased in size, 17 were stable, and 8 decreased (median imaging follow-up, 35 months; range, 10–113 months). Symptoms subsided in 15 patients (60%); vertigo occurred in 1, but balance improved with vestibular training (median clinical follow-up, 37 months; range, 11–118 months). No other new or progressive neuropathy of cranial nerves V–XII developed. Conclusions Stereotactic radiosurgery can achieve excellent tumor control with low risk of morbidity in the treatment of Glomus Jugulare tumors. The lower cranial nerves can safely tolerate a radiosurgical dose of 12 to 18 Gy. © 2002 Wiley Periodicals, Inc. Head Neck 24: 332–339, 2002; DOI 10.1002/hed.10005
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Stereotactic radiosurgery for Glomus Jugulare tumors: A preliminary report
International journal of radiation oncology biology physics, 1997Co-Authors: Robert L. Foote, Robert J. Coffey, Deborah A. Gorman, John D. Earle, Paula J. Schomberg, Robert W. Kline, Steven E. SchildAbstract:Purpose: This study was conducted to evaluate the toxicity and efficacy of stereotactic radiosurgery treatment of Glomus Jugulare tumors. Methods and Materials: Between March 1990 and January 1995, nine patients underwent stereotactic radiosurgery with the Leksell Gamma Knife Unit for Glomus Jugulare tumors. Previous treatment had failed in four patients. The seven female and two male patients had a median age of 67 years. Results: The median time from stereotactic radiosurgery to the most recent clinical follow-up was 20 months ( range 7-65 months). Subjectively, 7 of 9 patients noted a decrease in the intensity of their symptoms. Objectively, 8 of 9 tumors remained stable in size by serial magnetic resonance imaging scans and one was smaller. There was no acute or chronic toxicity. Conclusion: This early experience suggests that stereotactic radiosurgery is a promising treatment for Glomus Jugulare tumors. © 1997 Elsevier Science Inc.
Salomon Benabou - One of the best experts on this subject based on the ideXlab platform.
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stereotactic radiosurgery for the treatment of Glomus Jugulare tumors
Surgical Neurology International, 2013Co-Authors: Emerson Magno De Andrade, Jose Reginaldo Nascimento Brito, Susana Dias Mario, Suely Maymone De Melo, Salomon BenabouAbstract:Background: The Glomus Jugulare tumor is a slowly growing benign neoplasm originating from neural crest. There is a high morbidity associated with surgical resection of Glomus Jugulare. Radiosurgery play a relevant role as a therapeutic option in these tumors and its use has grown in popularity. The authors describe a retrospective series of 15 patients and reviewed the literature about the Glomus Jugulare tumors. Methods: We reviewed retrospectively the data of 15 patients treated with stereotactic linear accelerator stereotactic radiosurgery (LINAC) radiosurgery between 2006 and 2011. Results: The average tumor volume was 18.5 cm 3 . The radiation dose to the tumor margin ranged between 12 and 20 Gy. The neurological status improved in three patients and remained unchanged in 12 patients. One patient developed a transient 7 th nerve palsy that improved after clinical treatment. All tumors remained stable in size on follow-up with resonance magnetic images. Conclusions: The radiosurgery is a safe and effective therapy for patients with Glomus Jugulare tumor. Despite the short follow-up period and the limited number of patients analyzed, we can infer that radiosurgery produce a tumor growth control with low morbidity, and may be used as a good option to surgical resection in selected cases.