Hinerman R W, Mendenhall W M, Amdur R J, Stringer S P, Antonelli P J, Cassisi N J
Department of Radiation Oncology, University of Florida Health Science Center, PO Box 100385, Gainesville, Florida 32610-0385, USA.
Head Neck. 2001 May;23(5):363-71. doi: 10.1002/hed.1045.
To evaluate the results of treatment for 71 patients with 80 chemodectomas of the temporal bone, carotid body, or glomus vagale who were treated with radiation therapy (RT) alone (72 tumors in 71 patients) or subtotal resection and RT (8 tumors) at the University of Florida between 1968 and 1998.
Sixty-six lesions were previously untreated, whereas 14 had undergone prior treatment (surgery, 11 lesions; RT, 1 lesion; or both, 2 lesions) and were treated for locally recurrent disease. All three patients who received prior RT had been treated at other institutions. Patients had minimum follow-up times as follows: 2 years, 66 patients (93%); 5 years, 53 patients (75%); 10 years, 37 patients (52%); 15 years, 29 patients (41%); 20 years, 18 patients (25%); 25 years, 12 patients (17%); and 30 years, 4 patients (6%).
There were five local recurrences at 2.6 years, 4.6 years, 5.3 years, 8.3 years, and 18.8 years, respectively. Four were in glomus jugulare tumors and one was a carotid body tumor. Two of the four patients with glomus jugulare failures were salvaged, one with stereotactic radiosurgery and one with surgery and postoperative RT at another institution. Two of the five recurrences had been treated previously at other institutions with RT and/or surgery. Treatment for a third recurrence was discontinued, against medical advice, before receiving the prescribed dose. There were, therefore, only 2 failures in 65 previously untreated lesions receiving the prescribed course of RT. The overall crude local control rate for all 80 lesions was 94%, with an ultimate local control rate of 96% after salvage treatment. The incidence of treatment-related complications was low.
Irradiation offers a high probability of tumor control with relatively minimal risks for patients with chemodectomas of the temporal bone and neck. There were no severe treatment complications.
评估1968年至1998年间在佛罗里达大学接受单纯放射治疗（RT）（71例患者中的72个肿瘤）或次全切除加RT（8个肿瘤）的71例患有颞骨、颈动脉体或迷走神经球化学感受器瘤的患者的治疗结果。
66个病灶此前未接受过治疗，而14个曾接受过先前治疗（手术，11个病灶；RT，1个病灶；或两者皆有，2个病灶），并针对局部复发性疾病进行治疗。所有3例接受过先前RT的患者均在其他机构接受过治疗。患者的最短随访时间如下：2年，66例患者（93%）；5年，53例患者（75%）；10年，37例患者（52%）；15年，29例患者（41%）；20年，18例患者（25%）；25年，12例患者（17%）；30年，4例患者（6%）。
分别在2.6年、4.6年、5.3年、8.3年和18.8年出现5例局部复发。4例为颈静脉球瘤，1例为颈动脉体瘤。4例颈静脉球瘤复发患者中有2例得到挽救，1例接受立体定向放射外科治疗，1例在另一机构接受手术及术后RT。5例复发中有2例此前在其他机构接受过RT和/或手术治疗。第三例复发患者在未接受规定剂量治疗前，违反医嘱停止了治疗。因此，在65个此前未接受治疗的病灶中，接受规定疗程RT的仅有2例治疗失败。所有80个病灶的总体粗略局部控制率为94%，挽救治疗后的最终局部控制率为96%。与治疗相关的并发症发生率较低。
对于颞骨和颈部化学感受器瘤患者，放射治疗提供了较高的肿瘤控制概率，且风险相对较小。未出现严重的治疗并发症。
