ESTRO 2024 - Abstract Book

S1357

Clinical - Head & neck

ESTRO 2024

1906

Digital Poster

CyberKnife- and Gamma Knife-based SRT for Head and Neck Paragangliomas: A Single-Center Experience

Viola Salvestrini 1 , Niccolò Bertini 1 , Isacco Desideri 1 , Carlotta Becherini 1 , Daniela Greto 1 , Guido Pecchioli 2 , Pietro Garlatti 1 , Icro Meattini 1 , Erika Scoccimmarro 1 , Giulio Francolini 1 , Luca Visani 1 , Monica Mangoni 1 , Vanessa Di Cataldo 1 , Anna Peruzzi 1 , Carolina Orsatti 1 , Luca Burchini 1 , Pierluigi Bonomo 1 , Lorenzo Livi 1 1 Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy. 2 Neurosurgery Unit, Azienda Ospedaliero Universitaria Careggi, University of Florence,, Florence, Italy

Purpose/Objective:

Head and neck paragangliomas (HN-PGs) are slow-growing tumors with a good prognosis, arising from the autonomic nervous system. The management of HN-PGs is commonly based on a multidisciplinary approach, and radiation therapy plays a crucial role in the treatment strategy. The medical goal is to maximize local control while minimizing toxicity. RT has proven to be a safe and efficacious method in the management of HN-PGs, both in the upfront and post-operative setting. We report on the outcomes of a single-center cohort of patients (pts) treated with CyberKnife (CK)- and Gamma Knife (GK)- based stereotactic radiotherapy (SRT) for HN-PGs.

Material/Methods:

Consecutive pts who received CK- and GK- SRT for HNPGs in our institution between 2016 and 2022 were included. Data including age, gender, symptoms before SRS, side of radiation, history of previous operation or radiation, Fisch classification, dosimetric parameters for SRS, radiological response, changes in symptoms and treatment-related adverse events (TRAEs) were recorded. Toxicities were recorded according to Common Terminology Criteria for Adverse Events (CTCAE v5.0). Local control (LC) was defined as the absence of radiologic progression. Survival analysis were performed with Kaplan Meier method.

Results:

We retrospectively evaluated 19 pts treated with CK (15) - and GK (4) - SRT for temporal bone (12) and carotid (7) localization of HN-PGs (Fig.1). The most commonly adopted SRT schedules consisted of a total dose of 12-20 Gy, 24 Gy and 25 Gy delivered in 1, 3 and 5 fractions, respectively. Fish classification was available only for 8 out of 19 pts, of whom 2 were classified as Fish B and 6 as Fish C HN-PGs, respectively. At a median follow-up of 60 months [28 103 months] the LC rate was 94,7% (18/19 pts). The median age was 58 years [29-79 years] and GTV was 5,6 cm3 [0,2 - 41 cm3]. The symptomatic improvement has been observed in 12/19 pts (63%). Four pts had acute toxicity: grade (G) 1 dysphagia (1 pt), G2 dysgeusia (1pt), G1 esophagitis (1pt) and G3 mucositis (1pt). Only one patient experienced G1 late dysphagia.

Figure 1. Treatment planning and dosimetry of a carotid body paraganglioma treated with CK-SRT.