¬3-session vs 5-session dose-fractionation of stereotactic radiosurgery in Glomus Jugulare: Protocol for a Randomized Clinical Trial (Preprint)

Background: Gamma Knife stereotactic radiosurgery (SRS) is a pivotal therapeutic strategy for managing jugular paragangliomas (JP) due to the tumor's vascularity and the intricacies of regional anatomy.Noteworthy is the comparison between limited-session dose fractionation SRS and multisession fractionated Gamma Knife SRS, with the former being linked to a higher incidence of adverse effects on at-risk organs and the latter may be accompanied by lower rate of tumor control.Objective: The primary objective is to assess tumor size post-intervention, evaluated through MRI sequences at 6-month and 1-year intervals.Secondary objectives include alleviating tumor-associated symptoms, and documenting severe adverse outcomes.Methods: This document outlines a trial protocol for a comparative study evaluating the efficacy of 3-session versus 5-session fractionation in Gamma Knife SRS for JP.In this single-center prospective randomized clinical trial, 40 eligible JP patients will be randomly assigned to receive either three sessions of Gamma Knife SRS (cumulative radiation dose: 18-21 GY) or five sessions (cumulative radiation dose: 21-25 GY).Results: As of March 2024, the patient screening process has not begun, and no participants have been enrolled in the trial. Conclusions:Prior research reveals a significant gap in knowledge, hindering a comprehensive comparison of gamma knife radiosurgery dosage fractionations in JP.This protocol seeks to address this gap by investigating the impact of 3 sessions versus 5 sessions of dose-fractionated Gamma Knife SRS on JP.