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Objective. Over the last two decades there has been increasing evidence that radiosurgery and radiotherapy management of skull-base paragangliomas is as effective as microsurgical resection and carries less morbidity. This 10 year retrospective review of 24 patients in a single institution, treated...
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| Format: | Thesis |
| Language: | English |
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Department of Surgery
2020
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| _version_ | 1867613242839269376 |
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| access_status_str | Open Access |
| author | Wegoye, Emmanuel |
| author2 | Parkes, Jeannette |
| author_browse | Parkes, Jeannette Wegoye, Emmanuel |
| author_facet | Parkes, Jeannette Wegoye, Emmanuel |
| author_sort | Wegoye, Emmanuel |
| collection | Thesis |
| description | Objective. Over the last two decades there has been increasing evidence that radiosurgery and radiotherapy management of skull-base paragangliomas is as effective as microsurgical resection and carries less morbidity. This 10 year retrospective review of 24 patients in a single institution, treated over 10 years assesses tumour control rates and morbidity associated with radiosurgery and radiotherapy treatment. Method. Patients with a radiological diagnosis of skull-base paragangliomas were treated with different techniques of stereotactic and image-guided radiotherapy delivering hypo fractionated irradiation. Techniques used included conventional radiotherapy or intensity modulated radiotherapy (IMRT), dynamic arc (DA) and volumetric modulated arc therapy (VMAT). Analysis of local tumour control was performed using RECIST criteria and the KaplanMeier method. 69% of patients received 14-16gy in 1-3 fractions while 31% received 48- 50gy in 25 fractions. Radiation-associated toxicity was graded according to the commonly used Radiation therapy Oncology group (RTOG) toxicity criteria. Results. 24 patients with skull-base paragangliomas were treated with a median follow up of 43 months. One patient lost to follow up and was excluded. Tumour control was achieved in 96% of patients. 76% of patients treated reported no radiation associated toxicity. 24% of patients had some radiation associated toxicity: the conventional group 12%, stereotactic radiosurgery 8% and stereotactic radiotherapy 4%. 43% of patients in the conventional group had progression of hearing loss in the affected ear. One patient in the radiosurgery group developed osteonecrosis of the temporal bone at 5 year follow up. Conclusion. Radiosurgery and radiotherapy are efficacious in achieving tumour control with minimal morbidity. Tumour control rates in the study are similar to control rates in literature. Radiation associated toxicities are mainly minor. Study is limited by the retrospective nature and limited duration of follow up. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/30840 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:33:01.081Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2020 |
| publishDateRange | 2020 |
| publishDateSort | 2020 |
| publisher | Department of Surgery |
| publisherStr | Department of Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/30840 Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital Wegoye, Emmanuel Parkes, Jeannette Taylor, Allan Neurosurgery Objective. Over the last two decades there has been increasing evidence that radiosurgery and radiotherapy management of skull-base paragangliomas is as effective as microsurgical resection and carries less morbidity. This 10 year retrospective review of 24 patients in a single institution, treated over 10 years assesses tumour control rates and morbidity associated with radiosurgery and radiotherapy treatment. Method. Patients with a radiological diagnosis of skull-base paragangliomas were treated with different techniques of stereotactic and image-guided radiotherapy delivering hypo fractionated irradiation. Techniques used included conventional radiotherapy or intensity modulated radiotherapy (IMRT), dynamic arc (DA) and volumetric modulated arc therapy (VMAT). Analysis of local tumour control was performed using RECIST criteria and the KaplanMeier method. 69% of patients received 14-16gy in 1-3 fractions while 31% received 48- 50gy in 25 fractions. Radiation-associated toxicity was graded according to the commonly used Radiation therapy Oncology group (RTOG) toxicity criteria. Results. 24 patients with skull-base paragangliomas were treated with a median follow up of 43 months. One patient lost to follow up and was excluded. Tumour control was achieved in 96% of patients. 76% of patients treated reported no radiation associated toxicity. 24% of patients had some radiation associated toxicity: the conventional group 12%, stereotactic radiosurgery 8% and stereotactic radiotherapy 4%. 43% of patients in the conventional group had progression of hearing loss in the affected ear. One patient in the radiosurgery group developed osteonecrosis of the temporal bone at 5 year follow up. Conclusion. Radiosurgery and radiotherapy are efficacious in achieving tumour control with minimal morbidity. Tumour control rates in the study are similar to control rates in literature. Radiation associated toxicities are mainly minor. Study is limited by the retrospective nature and limited duration of follow up. 2020-01-30T13:55:26Z 2020-01-30T13:55:26Z 2019 2020-01-29T13:12:07Z Master Thesis Masters MMed http://hdl.handle.net/11427/30840 eng application/pdf Department of Surgery Faculty of Health Sciences |
| spellingShingle | Neurosurgery Wegoye, Emmanuel Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| thesis_degree_str | Master's |
| title | Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| title_full | Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| title_fullStr | Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| title_full_unstemmed | Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| title_short | Radiotherapy for head and neck paragangliomas: A 10 year retrospective review 2005-2014 at Groote Schuur Hospital and UCT Private academic hospital |
| title_sort | radiotherapy for head and neck paragangliomas a 10 year retrospective review 2005 2014 at groote schuur hospital and uct private academic hospital |
| topic | Neurosurgery |
| url | http://hdl.handle.net/11427/30840 |
| work_keys_str_mv | AT wegoyeemmanuel radiotherapyforheadandneckparagangliomasa10yearretrospectivereview20052014atgrooteschuurhospitalanductprivateacademichospital |