# Efficacy and Safety of Radiotherapy in Head and Neck Paragangliomas: A Retrospective 23-Year Analysis

## TL;DR

Radiotherapy, especially IMRT, is shown to be a safe and effective long-term treatment for head and neck paragangliomas with no recurrence or major side effects.

## Contribution

This study provides a 23-year retrospective analysis demonstrating the efficacy and safety of radiotherapy for HNPGs.

## Key findings

- All patients achieved stable or improved symptoms with no local recurrence over a median follow-up of 96 months.
- Radiotherapy was well tolerated with no acute or late toxicities ≥ grade 2.
- IMRT provided excellent long-term local control with minimal toxicity for unresectable or high-risk HNPG patients.

## Abstract

Background/Objectives: Head and neck paragangliomas (HNPGs) are rare, typically benign, hypervascular tumors arising from neural crest cells. Although surgery is known as the primary treatment, radiotherapy (RT) is preferred for large and inoperable tumors. This study evaluated the results and safety of RT. Methods: Fifteen patients with radiologically or histologically confirmed HNPG treated with RT between 2001 and 2024 were retrospectively analyzed. Most patients received intensity-modulated radiotherapy (IMRT) with a median dose of 45 Gy. Treatment-related toxicities were graded according to CTCAE criteria. Local control (LC) was estimated with using Wilson score method. Results: With a median follow-up of 96 months, all patients achieved stable or improved symptomes, without local recurrence, resulting in a 100% LC rate. RT was well tolerated, with no acute or late toxicities ≥ grade 2. Conclusions: RT, particularly IMRT, provides excellent long-term LC with minimal toxicity in patients with HNPG. RT represents an effective and well-tolerated treatment option, especially for patients with unresectable disease or high surgical risk.