Dall'Igna Celso, Antunes Marcelo B, Dall'Igna Daniela Pernigotti
UFRGS, ENT Services, Clinical Hospital, Porto Alegre.
Braz J Otorhinolaryngol. 2005 Nov-Dec;71(6):752-7. doi: 10.1016/s1808-8694(15)31244-1.
The treatment of glomic tumors has been controversial since its first description. It can be done with surgery, radiotherapy or just expectation.
The objective of this paper was to evaluate the effectiveness and complications of radiotherapy.
clinical with transversal cohort.
It was made a retrospective review in the charts of the patients with glomus jugulare tumors treated with radiotherapy. Disease control was determined by (1) no progression of symptoms or cranial nerve dysfunction or (2) no progression of the lesion in radiological follow-up. It was also evaluated the follow-up period and the sequelae of the treatment.
Twelve patients were included, 8 of then women. The follow-up period was from 3 to 35 years, with a media of 11,6 years. The main symptoms were: hearing loss, pulsate tinnitus, dizziness and vertigo. The signs were pulsate retrotympanic mass, facial palsy and cofosis. The tumors were staged using Fisch's classification. The radiotherapy was performed with linear accelerator with dose ranging from 4500-5500 in 4-6 weeks. In the follow-up period were possible to identify sequelaes like dermatitis, meatal stenosis, cofosis and facial palsy.
The signs and symptoms were the same found in the medical literature. The type and dosages of the radiotherapy were also the same of others reports. All patients had improvement of the symptoms and only one was not considered as having disease controlled. Complications were, in general, minor complications, with exception of the cofosis and facial palsy.
Radiotherapy is a viable alternative to treatment of these tumors because their good response and low level of complications. It should be considered specially in advanced tumors where a surgical procedure could bring a high level of morbidity.
自首次描述以来,球瘤的治疗一直存在争议。治疗方法可以是手术、放疗或仅观察等待。
本文的目的是评估放疗的有效性和并发症。
横向队列临床研究。
对接受放疗的颈静脉球瘤患者的病历进行回顾性分析。疾病控制的判定标准为:(1)症状或颅神经功能障碍无进展;或(2)影像学随访中病变无进展。同时评估随访时间和治疗后遗症。
纳入12例患者,其中8例为女性。随访时间为3至35年,平均11.6年。主要症状为:听力丧失、搏动性耳鸣、头晕和眩晕。体征为搏动性鼓膜后肿物、面瘫和共济失调。肿瘤采用菲施分类法分期。使用直线加速器进行放疗,剂量在4至6周内为4500 - 5500。在随访期间可发现皮炎、外耳道狭窄、共济失调和面瘫等后遗症。
体征和症状与医学文献中报道的一致。放疗的类型和剂量也与其他报道相同。所有患者症状均有改善,仅1例未达到疾病控制标准。一般来说,并发症为轻微并发症,但共济失调和面瘫除外。
放疗是治疗这些肿瘤的一种可行选择,因为其疗效良好且并发症发生率低。对于晚期肿瘤,尤其应考虑放疗,因为手术可能会带来较高的发病率。