What is your treatment approach for patients with base of skull glomus jugalare tumors (paraganglioma)?

Depending on the patient's performance status, size of tumor, and location within the skull base, I may opt for radiosurgery upfront or simply external beam radiotherapy. For radiosurgery, typically my dose is 16 Gy and for external beam may range from 45 to 50.4 Gy.

Fractionated RT to 45 Gy/25fx seems to be extremely efficacious with low morbidity in the age of IMRT. Here is the link to the University of Florida 45-year experience on the subject. SRS is also feasible if logistically that's difficult for the patient.