The efficacy and influencing factors of gamma knife radiosurgery for primary jugular foramen tumors

ABSTRACT Background: Gamma knife radiosurgery (GKRS) is a key treatment method for intracranial neoplasms, particularly primary jugular foramen tumors. The risks associated with surgical resection and conventional radiotherapy have prompted interest in GKRS, which facilitates precise, high-dose delivery with minimal collateral damage. Methods: This retrospective study comprised 219 patients with primary jugular foramen tumors treated from June 2014 to June 2024. The patients were divided into two groups based on the treatment received: conventional fractionated external beam radiotherapy (EBRT, n = 103) and GKRS ( n = 116). Treatment efficacy was evaluated using magnetic resonance imaging and the Response Evaluation Criteria in Solid Tumors criteria 6 months post-treatment. Correlation and regression analyses were conducted to identify factors affecting the treatment outcomes. Results: The GKRS group exhibited a significantly higher complete and partial response rates compared to the EBRT group (25.86% vs. 9.71% and 30.17% vs. 22.33%, respectively). The GKRS group showed a significantly lower rate of progressive disease (5.17% vs. 23.3%, P < 0.001) and fewer cranial nerve-related adverse effects ( P = 0.008) compared to the EBRT group. The factors predicting poor GKRS efficacy included a large tumor volume, intra-/extracranial extension, and transient expansion ( P = 0.005, 0.010, and 0.005, respectively). Conclusion: GKRS demonstrated superior efficacy and a better safety profile than EBRT for managing primary jugular foramen tumors. Tumor type, volume, and morphology significantly influenced GKRS outcomes, highlighting the need for tailored treatment strategies based on individual tumor characteristics.