Efficiency of gamma knife radiosurgery in the treatment of glomus jugularetumors

This study was performed to assess the impact of gamma knife radiosurgery ( RS) in the treatment of glomus jugulare tumors. Between February 1993 and F ebruary 1999, thirteen patients (9 women, 4 men, mean age 63.5 years, range 29 to 79 years) underwent stereotactic radiosurgery for glomus jugulare tu mors with the Leksell Gamma Knife at the Neurosurgical Department of the Un iversity of Vienna. Four patients, mean age 74.5 years, range 67 to 79 year s, underwent radiosurgery as the only treatment. Nine patients received rad iosurgery as adjuvant therapy after previous treatment had failed: surgical resection in 9 patients and additional fractionated external beam radiatio n in two of these patients. Pretreatment evaluation included the staging of all tumors according to the Fisch Classification: Del (7), De2 (1), Di1 (4 ) and Di2 (1). The mean followup period was 4.2 years, range 0.7 to 6.7 yea rs. Ten patients, 77 %, were treated prior to 1997, the mean follow-up peri od being 5 years. Six patients showed no clinical changes, while six experi enced an improvement of their clinical symptoms and neurological deficits. One patient was lost to follow-up. Radiation-induced transient cranial nerv e neuropathies were observed in two patients. Serial MRI scans revealed tum or control in all patients, with unaltered tumor size in 10 and shrinkage i n three patients. The results indicate that RS is an attractive treatment o ption for glomus jugulare tumors and will occupy an increasingly important role in the management of these tumors in selected patients.