Radiation Therapy for Benign Diseases and Premalignant Conditions

Radiation therapy (RT), traditionally reserved for malignant conditions, has emerged as a valuable tool in the management of select benign tumors and proliferative disorders. In clinical scenarios where surgery is not feasible, incomplete, or associated with significant morbidity, RT offers a noninvasive and effective alternative, often yielding excellent local control and long-term symptom relief. For instance, although surgery is relatively safe and effective, radiation is the preferred treatment for many patients with acoustic neuroma. Many benign entities have demonstrated favorable responses to radiation [1]. Among these, paragangliomas (PGL)—notably glomus jugulare tumors—have emerged as prime examples where RT plays a critical role. These tumors, while histologically benign, often present with local invasiveness, cranial nerve involvement, and high recurrence rates, making complete surgical resection difficult and frequently associated with significant morbidity. Beyond PGLs, RT has shown promise in a range of other benign conditions, including many benign vascular and lymphoid disorders [2–4]. These entities, although benign, may behave in an infiltrative or recurrent manner, necessitating a multidisciplinary approach to treatment. In particular, localized lymphoid lesions may benefit from RT. This section focuses specifically on the role of RT in the management of PGL, pheochromocytoma (PCC), hemangioma, ameloblastoma, angiofibroma, Castleman disease, cutaneous pseudolymphoma, and adamantinoma. Other benign entities are discussed in a separate section of the current issue.