The Role of Radiation Therapy in the Management of Head and Neck Paragangliomas: Impact of Quality of Life Versus Treatment Response

Radiother Oncol. 2014 Jun;111(3):463-7. doi: 10.1016/j.radonc.2014.06.002. Epub 2014 Jul 1.

Abstract

Purpose: To assess the impact of radiotherapy in paragangliomas (PGLs) with regard to overall survival, local control, volumetric response and particularly quality of life (QoL).

Materials and methods: From 1985 to 2010, 130 cases of head and neck (H&N) PGLs were managed at Bordeaux University Hospital. With a median follow-up of 7.6 years, we retrospectively present a cohort of 30 consecutive patients treated with radiation therapy for H&N PGLs. QoL was evaluated for 20 patients by the EORTC QLQ-C30 and H&N35 questionnaires through a cross-sectional study.

Results: The 5-year overall survival and local control were 95% and 96% respectively. QoL is altered following management of PGLs. The H&N35 score is lower after combined modality therapy (surgery±embolization and radiation therapy) for speech and hearing (p=0.004), trismus (p=0.003) and total score (p=0.01) than after radiotherapy alone. Tumor shrinkage was significant at 2 and 3 years after radiotherapy (p=0.018; p=0.043).

Conclusion: Ultimate QoL should be a major goal of any treatment strategy for this benign disease. Definitive radiotherapy should be considered as a reasonable alternative to multimodality treatment as it provides comparable disease control with an apparent improvement in QoL.

Keywords: Head and neck paragangliomas; Quality of life; Radiation therapy; Tumor response.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Head and Neck Neoplasms / physiopathology
  • Head and Neck Neoplasms / psychology
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Male
  • Middle Aged
  • Paraganglioma / radiotherapy*
  • Quality of Life
  • Retrospective Studies
  • Surveys and Questionnaires
  • Young Adult