A paraganglioma is a rare but treatable neuroendocrine tumor that usually forms along major blood vessels and nerve pathways in your neck and head. In most cases, the tumor is benign, but it can be malignant (cancer). Symptoms include high blood pressure and headaches, though you could experience no symptoms.
A systemic review was done to determine if Stereotactic Radiosurgery (SRS), like CyberKnife or Gamma Knife was the best choice to remove such tumors, or if conventional surgery, which is often the first choice to remove the tumor is the better choice.
Here is the conclusion: SRS is a viable alternative or adjunct to surgical intervention in FPG, achieving favorable clinical, hormonal, and radiological outcomes with minimal morbidity. Our findings challenge the conventional view of the radioresistance of FPG, highlighting the potential for sustained biochemical and symptomatic control.
Here’s the full research report on the systemic review:
Revisiting radioresistance: a systematic review of outcomes of Stereotactic radiosurgery (SRS) in functional head and neck paragangliomas
Abstract
This systematic review evaluates the role of stereotactic radiosurgery (SRS) in managing functional head and neck paragangliomas (FPG), which pose unique challenges due to catecholamine secretion and associated functional symptoms.
Currently there are no established management guidelines for FPG because of their rarity.
We explore clinical, radiological and hormonal outcomes of SRS and conventional radiotherapy (RT), challenging traditional assumptions of radioresistance in FPG.
Following PRISMA guidelines, databases including PubMed, Scopus, Web of Science, ResearchGate, Google Scholar, and Embase were searched for English-language studies on SRS for head and neck paragangliomas (HNPG) up to December 2024.
Studies reporting clinical, radiological, or hormonal outcomes for FPG treated with SRS were included.
Data extraction focused on tumor location, SRS parameters, clinical symptoms, and follow-up results.
We included eight studies, documenting 10 cases of FPG treated with SRS.
Tumors were located in the jugular (6 cases), Jugulo-tympanic (3 cases), and carotid body (1 case).
Seven cases were treated with Gamma Knife Radiosurgery (GKRS), while CyberKnife was used in three. Primary SRS was performed in three cases, and five underwent secondary SRS for residual or recurrent disease.
Hormonal outcomes showed normalization of catecholamine levels in six cases 30-36 months post-SRS.
There was resolution of functional symptoms in all cases treated with high-dose SRS.
Bottomline: SRS is a viable alternative or adjunct to surgical intervention in FPG, achieving favorable clinical, hormonal, and radiological outcomes with minimal morbidity.
Our findings challenge the conventional view of the radioresistance of FPG, highlighting the potential for sustained biochemical and symptomatic control.
The limited number of cases underscores the need for future studies with standardized outcome reporting to refine therapeutic strategies for this rare condition.
CyberKnife Radiation Therapy for Head & Neck Tumors
CyberKnife therapy has long been used to successfully treat persistent head and neck tumors including brain and thyroid cancer.
The CyberKnife uses highly focused and precisely aimed radiation beams that destroy tumors while sparing surrounding healthy tissue. It’s much more accurate than any other type of radiation.
CyberKnife, also known as stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT), is the most cutting-edge radiation technology available today. It’s used to destroy tumors and lesions throughout the body with pinpoint accuracy, leaving surrounding healthy tissue unharmed.
There’s no cutting, incision, blood, anesthesia, or pain; few, if any, side effects; and no recovery time. You can resume your normal activities immediately following treatment.
Each treatment typically lasts 30 to 60 minutes and is performed on an outpatient basis. Patients typically require only one to five treatments. If tumors come back, we often can treat them again.
The medical team will determine the size of the area that must be targeted by radiation and the radiation dose needed to ablate the tumor. They also will identify critical structures where radiation should be minimized.
The CyberKnife will move slowly around you during treatment, and you won’t feel a thing. It’s completely pain free. Patients dress comfortably in their own clothes and can bring music to listen to during the treatment. Nothing will be required of the patient during the treatment, except to relax. In fact, patients often sleep through the treatment.
Keep in mind that the tumor will not suddenly disappear. In fact it could take several weeks or longer to determine the effectiveness of the CyberKnife treatment.
Response to treatment varies from patient to patient. Clinical experience has shown that most patients respond very well to CyberKnife treatments.
CyberKnife radiosurgery has been used for more than two decades with extremely high rates of tumor control, and most head and neck cancer patients are good candidates for it.
Rest assured at CyberKnife Miami, you’re working with the some of the most experienced and highly trained radiation oncologists, surgeons, medical physicists, and radiation therapists in the world. They will meticulously map out a treatment plan for your specific needs.
They will oversee your entire procedure, ensuring your experience is as successful and comfortable as possible.
If you have a tumor it’s critical to understand your treatment options. To find out if you’re a candidate for life-saving CyberKnife radiosurgery, call the CyberKnife Center of Miami at (800) 204-0455.