Endovascular embolization as a stand-alone treatment of head and neck paragangliomas with long-term tumor control.

Journal

AJNR. American journal of neuroradiology
ISSN: 1936-959X
Titre abrégé: AJNR Am J Neuroradiol
Pays: United States
ID NLM: 8003708

Informations de publication

Date de publication:
07 May 2024
Historique:
received: 21 11 2023
accepted: 30 04 2024
medline: 9 5 2024
pubmed: 9 5 2024
entrez: 8 5 2024
Statut: aheadofprint

Résumé

The impact of therapeutic embolization as a stand-alone treatment of head and neck paragangliomas considered surgically high-risk remains insufficiently understood. The aim of this study was to investigate the procedural risks and long-term volumetric development in head and neck paragangliomas with high surgical risk following therapeutic endovascular embolization as stand-alone treatment. A retrospective database review of patients who underwent endovascular embolization as primary treatment for head and neck paragangliomas lacking appropriate curative treatment options at our institution (from January 2000 to February 2023) was conducted. Tumor volumetric analyses were performed before embolization and during follow-up. To assess the changes in tumor volume over time, the measurements were performed after embolization, first at 6 months and then on a yearly basis up to 6 years (mean follow-up time was: 33.7 ± 24.4 months). Subgroup analyses were conducted for vagal and jugular/jugulotympanic paragangliomas. A total of 32 head and neck paragangliomas in 28 patients (mean age, 56.1 years ± 16.5 [standard deviation]; 18 female) with therapeutic embolization as stand-alone treatment were evaluated, of which 11 were vagal paragangliomas, 15 jugular/jugulotympanic paragangliomas and 6 carotid body tumors. After a mean follow-up duration of 33.7 ± 24.4 months tumor control was achieved in 75%, with significant median tumor volume reduction at 6 months (p = .02, n = 21). Vagal paragangliomas responded the most to embolization with a significantly decreased median volume from 22.32 cm Therapeutic embolization as a stand-alone treatment offers a low-risk control of tumor growth in surgically high-risk lesions, with a significant reduction in tumor volume after treatment. Among the different subtypes, vagal paragangliomas exhibited the strongest and longest regression of the tumor volume.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
The impact of therapeutic embolization as a stand-alone treatment of head and neck paragangliomas considered surgically high-risk remains insufficiently understood. The aim of this study was to investigate the procedural risks and long-term volumetric development in head and neck paragangliomas with high surgical risk following therapeutic endovascular embolization as stand-alone treatment.
MATERIALS AND METHODS METHODS
A retrospective database review of patients who underwent endovascular embolization as primary treatment for head and neck paragangliomas lacking appropriate curative treatment options at our institution (from January 2000 to February 2023) was conducted. Tumor volumetric analyses were performed before embolization and during follow-up. To assess the changes in tumor volume over time, the measurements were performed after embolization, first at 6 months and then on a yearly basis up to 6 years (mean follow-up time was: 33.7 ± 24.4 months). Subgroup analyses were conducted for vagal and jugular/jugulotympanic paragangliomas.
RESULTS RESULTS
A total of 32 head and neck paragangliomas in 28 patients (mean age, 56.1 years ± 16.5 [standard deviation]; 18 female) with therapeutic embolization as stand-alone treatment were evaluated, of which 11 were vagal paragangliomas, 15 jugular/jugulotympanic paragangliomas and 6 carotid body tumors. After a mean follow-up duration of 33.7 ± 24.4 months tumor control was achieved in 75%, with significant median tumor volume reduction at 6 months (p = .02, n = 21). Vagal paragangliomas responded the most to embolization with a significantly decreased median volume from 22.32 cm
CONCLUSIONS CONCLUSIONS
Therapeutic embolization as a stand-alone treatment offers a low-risk control of tumor growth in surgically high-risk lesions, with a significant reduction in tumor volume after treatment. Among the different subtypes, vagal paragangliomas exhibited the strongest and longest regression of the tumor volume.

Identifiants

DOI: 10.3174/ajnr.A8328 PMID: 38719606
pubmed: 38719606
pii: ajnr.A8328
doi: 10.3174/ajnr.A8328
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 by American Journal of Neuroradiology.

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest related to the content of this article.

Auteurs

Samira Michel (S)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Riccardo Ludovichetti (R)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Gergely Bertalan (G)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Patrick Thurner (P)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Jawid Madjidyar (J)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Tilman Schubert (T)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Martina Broglie Däppen (MB)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Svenja Nölting (S)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Alexander Huber (A)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Zsolt Kulcsar (Z)

From the Faculty of Medicine (S.M.), University of Zurich, Zurich, Switzerland; Department of Neuroradiology (R.L., G.B., P.T., J.M., T.S., Z.K.), Clinical Neuroscience Center, University Hospital of Zurich, Zurich, Switzerland; Department of Otorhinolaryngology (M.B., A.H.), Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland; Department of Endocrinology (S.N.), Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland.

Classifications MeSH