Fancello Giuseppe, Fancello Virginia, Ehsani Diana, Porpiglia Vincenzo, Piras Gianluca, Caruso Antonio, Sanna Mario
Department of Otology and Skull Base Surgery, Otologic Group, 29121, Piacenza, Italy.
Department of Otorhinolaryngology, Careggi University Hospital, 50134, Florence, Italy.
Eur Arch Otorhinolaryngol. 2024 Jun;281(6):2779-2789. doi: 10.1007/s00405-023-08413-y. Epub 2024 Jan 6.
Tympanojugular paragangliomas (TJ PGLs) are rare tumors characterized by bone infiltration and erosion and a close relationship with critical structures, such as cranial nerves and internal carotid artery. For these reasons, their management represents a tough challenge. Since the fifties, radio-therapy (RT) has been proposed as an alternative treatment aimed at avoiding tumor progression. However, the indolent nature of the tumor, characterized by slow growth, is a crucial factor that needs to be considered before offering radiation.
This study aims to examine tumor progression in RT patients through a systematic review of the literature and in TJ PGL patients who underwent solely wait and scan at our department.
The rate of tumor progression in the RT group was 8.9%, while in the wait and scan cohort was 12.9%. This data suggests the innate slow growth of PGLs. However, it is not possible to draw certain conclusions because of the wide heterogeneity of the studies.
When complete surgical excision of TJ PGLs is not feasible, appropriate counseling and patient selection, including comprehensive tumor classification, should be performed before proposing RT to control tumor progression, since wait and scan may represent a reasonable option in selected cases.
鼓室颈静脉副神经节瘤（TJ PGLs）是一种罕见肿瘤，其特征为骨质浸润和侵蚀，并与重要结构（如颅神经和颈内动脉）关系密切。由于这些原因，其治疗是一项严峻挑战。自五十年代以来，放射治疗（RT）就被提议作为一种旨在避免肿瘤进展的替代治疗方法。然而，肿瘤生长缓慢的惰性本质是在进行放疗前需要考虑的关键因素。
本研究旨在通过对文献的系统回顾以及对在我们科室仅接受观察和扫描的TJ PGL患者进行研究，来检查接受放疗患者的肿瘤进展情况。
放疗组的肿瘤进展率为8.9%，而观察和扫描队列中的进展率为12.9%。该数据表明PGLs具有内在的缓慢生长特性。然而，由于研究的广泛异质性，无法得出确切结论。
当完全手术切除TJ PGLs不可行时，在提议放疗以控制肿瘤进展之前，应进行适当的咨询和患者选择，包括全面的肿瘤分类，因为在某些选定病例中，观察和扫描可能是一种合理的选择。
