RT Journal Article
SR Electronic
T1 Endovascular Embolization as a Stand-Alone Treatment of Head and Neck Paragangliomas with Long-Term Tumor Control
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1499
OP 1505
DO 10.3174/ajnr.A8328
VO 45
IS 10
A1 Michel, Samira
A1 Ludovichetti, Riccardo
A1 Bertalan, Gergely
A1 Thurner, Patrick
A1 Madjidyar, Jawid
A1 Schubert, Tilman
A1 Däppen, Martina Broglie
A1 Nölting, Svenja
A1 Huber, Alexander
A1 Kulcsar, Zsolt
YR 2024
UL http://www.ajnr.org/content/45/10/1499.abstract
AB BACKGROUND AND PURPOSE: 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 a stand-alone treatment.MATERIALS AND 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: 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 cm3 to 19.09 cm3 (P = .008, n = 8). Transient complications occurred in 3.4%.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.HNPGLhead and neck paragangliomaIQRinterquartile rangeJTPjugular/jugulotympanic paragangliomaPVApolyvinyl alcoholSDHsuccinate dehydrogenaseVPvagal paraganglioma