Carotid body tumour--a case for radiotherapy?

Carotid body tumours are rare tumours in the head and neck region. Treatment has been surgery with little or no role for radiotherapy. We describe 5 patients with carotid body tumours seen in our department in the last 10 years. Two patients were treated with postoperative radiotherapy after incomplete surgery, 2 had inoperable tumours and were treated with radiotherapy alone, and 1 had a complete excision and required follow-up only. In the 4 patients who received radiotherapy, the disease was stable in 1 patient at 1,1 years and progressive in 2 at 0,6 and 5,6 years respectively; 1 patient did not complete treatment. The patient who had surgery alone for a small tumour was free of disease at 1 year. Small carotid body tumours should be treated with surgery alone. When the tumour is large or the patient is older we propose radiotherapy as initial treatment because of the high morbidity of surgery. A review of the literature and the results with radiotherapy alone in varying doses support this view.