Treatment and Prognosis of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Multi-Institutional Retrospective Review of 87 Patients

Journal Article · Wed Aug 01 04:00:00 EDT 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.01.052· OSTI ID:20953587

Ogawa, Kazuhiko ^[1]; Nakamura, Katsumasa ^[2]; Hatano, Kazuo ^[3]; Uno, Takashi ^[4]; Fuwa, Nobukazu ^[5]; Itami, Jun ^[6]; Kojya, Shizuo ^[7]; Nakashima, Torahiko ^[8]; Shinhama, Akihiko ^[9]; Nakagawa, Takashi ^[10]; Toita, Takafumi ^[1]; Sakai, Mitsuhiro ^[3]; Kodaira, Takeshi ^[5]; Suzuki, Mikio ^[9]; Ito, Hisao ^[4]; Murayama, Sadayuki ^[1]

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1. Department of Radiology, University of the Ryukyus, Okinawa (Japan)
2. Department of Clinical Radiology, Kyushu University, Fukuoka (Japan)
3. Department of Radiation Oncology, Chiba Cancer Center, Chiba (Japan)
4. Department of Radiation Oncology, Chiba University, Chiba (Japan)
5. Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan)
6. Department of Radiation Therapy and Oncology, International Medical Center of Japan, Tokyo (Japan)
7. Department of Otorhinolaryngology, Heart Life Hospital, Okinawa (Japan)
8. Department of Otorhinolaryngology, Kyushu University, Fukuoka (Japan)
9. Department of Otorhinolaryngology, University of the Ryukyus, Okinawa (Japan)
10. Department of Otorhinolaryngology, Fukuoka University, Fukuoka (Japan)

Purpose: To examine the relative roles of surgery, radiotherapy, and chemotherapy in the management of patients with squamous cell carcinomas of the external auditory canal and middle ear. Methods and Materials: The records of 87 patients with histologically confirmed squamous cell carcinoma who were treated between 1984 and 2005 were reviewed. Fifty-three patients (61%) were treated with surgery and radiotherapy (S + RT group) and the remaining 34 patients with radiotherapy alone (RT group). Chemotherapy was administered in 34 patients (39%). Results: The 5-year actuarial overall and disease-free survival (DFS) rates for all patients were 55% and 54%, respectively. On univariate analysis, T stage (Stell's classification), treatment modality, and Karnofsky performance status had significant impact on DFS. On multivariate analysis, T stage and treatment modality were significant prognostic factors. Chemotherapy did not influence DFS. The 5-year DFS rate in T1, T2, and T3 patients was 83%, 45%, and 0 in the RT group (p < 0.0001) and 75%, 75%, and 46% in the S + RT group (p = 0.13), respectively. The 5-year DFS rate in patients with negative surgical margins, those with positive margins, and those with macroscopic residual disease was 83%, 55%, and 38%, respectively (p = 0.007). Conclusions: Radical radiotherapy is the treatment of choice for early-stage (T1) diseases, whereas surgery (negative surgical margins if possible) with radiotherapy is recommended as the standard care for advanced (T2-3) disease. Further clarification on the role of chemotherapy is necessary.

• OSTI ID: 20953587
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 68; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AUDITORY ORGANS
CARCINOMAS
CHEMOTHERAPY
MULTIVARIATE ANALYSIS
PATIENTS
RADIOTHERAPY
REVIEWS
SURGERY