{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:05Z","timestamp":1787028665493,"version":"build-2736575974"},"reference-count":38,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>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 \u2265 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.<\/jats:p>","DOI":"10.3390\/jcm15031062","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T10:08:57Z","timestamp":1769681337000},"page":"1062","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Radiotherapy in Head and Neck Paragangliomas: A Retrospective 23-Year Analysis"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7467-6917","authenticated-orcid":false,"given":"Kimia","family":"Cepni","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, 34840 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2009-0002","authenticated-orcid":false,"given":"Meltem","family":"Dagdelen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Cerrahpasa Medical Faculty Hospital, 34098 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9152-736X","authenticated-orcid":false,"given":"Huseyin","family":"Oner","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, 34840 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahar","family":"Cepni","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9930-7197","authenticated-orcid":false,"given":"Huriye Senay","family":"Kiziltan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Basaksehir Cam and Sakura City Hospital, University of Health Sciences, 34840 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer Erol","family":"Uzel","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Cerrahpasa Medical Faculty Hospital, 34098 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1016\/S0030-6665(05)70351-0","article-title":"Paragangliomas: Classification, pathology, and differential diagnosis","volume":"34","author":"Wasserman","year":"2001","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0030-6665(20)31720-5","article-title":"Paragangliomas of the head and neck","volume":"19","author":"Sykes","year":"1986","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"25","DOI":"10.5005\/jp-journals-10003-1051","article-title":"The Role of Radiotherapy in the Management of Paraganglioma","volume":"3","author":"Trombetta","year":"2011","journal-title":"Otorhinolaryngol. Clin. Int. J."},{"key":"ref_4","first-page":"339","article-title":"Clinical characteristics and remedies in 45 Iranians with carotid body tumors","volume":"50","author":"Nazari","year":"2012","journal-title":"Acta Med. Iran."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"19","DOI":"10.6061\/clinics\/2012(Sup01)05","article-title":"Head and neck paragangliomas: Clinical and molecular genetic classification","volume":"67","author":"Offergeld","year":"2012","journal-title":"Clinics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1007\/s12105-009-0130-5","article-title":"Paraganglioma: Carotid body tumor","volume":"3","author":"Wieneke","year":"2009","journal-title":"Head Neck Pathol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1111\/cen.12074","article-title":"Evaluation of SDHB, SDHD and VHL gene susceptibility testing in the assessment of individuals with non-syndromic phaeochromocytoma, paraganglioma and head and neck paraganglioma","volume":"78","author":"Jafri","year":"2013","journal-title":"Clin. Endocrinol."},{"key":"ref_8","first-page":"508","article-title":"Head and neck paragangliomas","volume":"71","author":"Werter","year":"2013","journal-title":"Neth. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1002\/hed.25611","article-title":"Paraganglioma of the head and neck region, treated with radiation therapy, a Rare Cancer Network study","volume":"41","author":"Ozyar","year":"2019","journal-title":"Head Neck"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/s10689-004-2154-z","article-title":"Paragangliomas of the head and neck: Diagnosis and treatment","volume":"4","author":"Boedeker","year":"2005","journal-title":"Fam. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"883","DOI":"10.3174\/ajnr.A0948","article-title":"Head and Neck Paragangliomas: Value of Contrast-Enhanced 3D MR Angiography","volume":"29","author":"Neves","year":"2008","journal-title":"Am. J. Neuroradiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1016\/j.ejrad.2003.12.002","article-title":"The value of MR angiography techniques in the detection of head and neck paragangliomas","volume":"52","author":"Schepers","year":"2004","journal-title":"Eur. J. Radiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40644-016-0084-2","article-title":"(68)Ga-DOTATATE and (18)F-FDG PET\/CT in Paraganglioma and Pheochromocytoma: Utility, patterns and heterogeneity","volume":"16","author":"Chang","year":"2016","journal-title":"Cancer Imaging"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2088","DOI":"10.1002\/hed.24871","article-title":"Feasibility of a wait-and-scan period as initial management strategy for head and neck paraganglioma","volume":"39","author":"Jansen","year":"2017","journal-title":"Head Neck"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/S0936-6555(05)80868-4","article-title":"Malignant paraganglioma with skeletal metastases and spinal cord compression: Response and palliation with chemotherapy","volume":"5","author":"Mertens","year":"1993","journal-title":"Clin. Oncol. (R. Coll. Radiol.)"},{"key":"ref_16","first-page":"1","article-title":"Optimal Screening for Hereditary Head and Neck Paraganglioma in Asymptomatic SDHx Variant Carriers in the Netherlands","volume":"86","author":"Heesters","year":"2025","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1038\/s41574-021-00492-3","article-title":"International consensus on initial screening and follow-up of asymptomatic SDHx mutation carriers","volume":"17","author":"Amar","year":"2021","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3785","DOI":"10.1016\/j.radcr.2022.07.010","article-title":"Carotid paragangliomas. Alternatives for presurgical endovascular management","volume":"17","author":"Sanchez","year":"2022","journal-title":"Radiol. Case Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1016\/j.jvs.2012.03.037","article-title":"Impact of preoperative embolization on outcomes of carotid body tumor resections","volume":"56","author":"Power","year":"2012","journal-title":"J. Vasc. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1002\/hed.21790","article-title":"Head and neck paragangliomas: Report of 175 patients (1989\u20132010)","volume":"34","author":"Papaspyrou","year":"2012","journal-title":"Head Neck"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/000348948209100502","article-title":"Infratemporal fossa approach for glomus tumors of the temporal bone","volume":"91","author":"Fisch","year":"1982","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2486","DOI":"10.1002\/hed.26277","article-title":"Head and neck paragangliomas: 30-year experience","volume":"42","author":"Valero","year":"2020","journal-title":"Head Neck"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1177\/0194599815627667","article-title":"Head and Neck Paragangliomas: An Update on Evaluation and Management","volume":"154","author":"Moore","year":"2016","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e292","DOI":"10.1016\/j.ijrobp.2022.07.1322","article-title":"Definitive Radiotherapy for Head and Neck Paragangliomas\u2014A Single-Institution 30-Year Experience","volume":"114","author":"Johnny","year":"2022","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/MAO.0000000000003781","article-title":"Systematic Review and Meta-analysis for Surgery Versus Stereotactic Radiosurgery for Jugular Paragangliomas","volume":"44","author":"Campbell","year":"2023","journal-title":"Otol. Neurotol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1097\/COC.0b013e318187dd94","article-title":"Paraganglioma of the head and neck: Long-term local control with radiotherapy","volume":"32","author":"Chino","year":"2009","journal-title":"Am. J. Clin. Oncol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"454","DOI":"10.5603\/rpor.101802","article-title":"Debulking surgery prior to stereotactic radiotherapy for head and neck paragangliomas","volume":"29","author":"Mauro","year":"2024","journal-title":"Rep. Pract. Oncol. Radiother."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/coa.13046","article-title":"Results of a systematic literature review of treatment modalities for jugulotympanic paraganglioma, stratified per Fisch class","volume":"43","author":"Jansen","year":"2018","journal-title":"Clin. Otolaryngol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1097\/MAO.0000000000002461","article-title":"Long-term Outcomes for the Treatment of Paragangliomas in the Upfront, Adjuvant, and Salvage Settings With Stereotactic Radiosurgery and Intensity-modulated Radiotherapy","volume":"41","author":"Anderson","year":"2020","journal-title":"Otol. Neurotol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1002\/hed.26497","article-title":"Long term outcomes with linear accelerator stereotactic radiosurgery for treatment of jugulotympanic paragangliomas","volume":"43","author":"Patel","year":"2021","journal-title":"Head Neck"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1002\/lary.30226","article-title":"Long-Term Outcomes in Head and Neck Paragangliomas Managed with Intensity-Modulated Radiotherapy","volume":"133","author":"Rougier","year":"2023","journal-title":"Laryngoscope"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3738","DOI":"10.1002\/cncr.28923","article-title":"Radiotherapy for benign head and neck paragangliomas: A 45-year experience","volume":"120","author":"Gilbo","year":"2014","journal-title":"Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1007\u20131020, vii\u2013viii","DOI":"10.1016\/S0030-6665(05)70360-1","article-title":"Treatment of paragangliomas with radiation therapy","volume":"34","author":"Mendenhall","year":"2001","journal-title":"Otolaryngol. Clin. N. Am."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/0360-3016(80)90317-X","article-title":"Optimum dose of radiotherapy for chemodectomas of the middle ear","volume":"6","author":"Kim","year":"1980","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1159\/000360864","article-title":"A retrospective analysis of tumor volumetric responses to five-fraction stereotactic radiotherapy for paragangliomas of the head and neck (glomus tumors)","volume":"92","author":"Chun","year":"2014","journal-title":"Stereotact. Funct. Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.ijrobp.2006.02.020","article-title":"Long-term results of irradiation for paraganglioma","volume":"65","author":"Krych","year":"2006","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.wneu.2011.03.026","article-title":"Stereotactic radiosurgery as the primary treatment for new and recurrent paragangliomas: Is open surgical resection still the treatment of choice?","volume":"77","author":"Lieberson","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1177\/000348947408300106","article-title":"Glomus jugulare tumors. II. A clinicopathologic analysis of the effects of radiotherapy","volume":"83","author":"Spector","year":"1974","journal-title":"Ann. Otol. Rhinol. Laryngol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1062\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T10:25:53Z","timestamp":1769682353000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/3\/1062"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,29]]},"references-count":38,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,2]]}},"alternative-id":["jcm15031062"],"URL":"https:\/\/doi.org\/10.3390\/jcm15031062","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,29]]}}}