Concomitant Chemoradiotherapy as a Standard Treatment for Squamous Cell Carcinoma of the Temporal Bone

Abstract

We sought to characterize the effectiveness of concomitant chemoradiotherapy (CCRT) for patients with squamous cell carcinoma of the temporal bone. We performed a retrospective chart review of 14 patients with cancer of the temporal bone who were provided initial treatment in our hospital from December 2001 to November 2008. Four patients with stage I tumors were treated by radiation therapy alone or with oral administration of S1. One patient with a stage II tumor was treated by radiation therapy concomitant with low dose docetaxel. Nine patients with stage IV tumors were treated by CCRT using the TPF regimen (docetaxel, cisplatin, and 5-fluorouracil). As an initial treatment, all patients but one were treated by radiation therapy with or without chemotherapy. Grade 4 adverse events of patients who received CCRT using the TPF regimen involved the leukopenia in one patient and the neutropenia in two patients. Local recurrences were observed in three patients including two patients with T4 tumors. Five-year disease-specific survival rates for all patients and for patients with T4 tumors were 78% and 67%, respectively. CCRT using the TPF regimen is safe and effective as the first treatment for patients with cancer of the temporal bone.

Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone

“…On the basis of favorable oncologic results for T4 diseases obtained with this procedure, they recommended CCRT with TPF as a standard treatment for locally advanced squamous cell carcinoma. The overall survival rate for patients with unresectable T4 tumors in our study was 56%, which agrees with the rate reported by Shiga et al Although the sample size for both studies was small, the prognosis for patients treated with CCRT tended to be better than for those treated with the other modalities. Especially noteworthy is that 80% of the patients with T3 or T4 disease without lymph node metastasis or expansive dural invasion in our study have survived without disease for >3 years.…”

“…To improve the locoregional control of CCRT, Tsukuda et al developed CCRT using TPF. In the phase I trial, CCRT with TPF was well tolerated and efficacious for patients with locally advanced squamous cell carcinoma of the head and neck, but was associated with a high incidence(79%) of severe mucositis (grade 3 and 4), which prevented this protocol from being accepted as standard therapy for advanced head and neck cancers. Irradiation of temporal bone cancer, however, involves only a limited part of the pharyngeal mucosa.…”

Right dominance in the incidence of external auditory canal squamous cell carcinoma in the Japanese population: Does handedness affect carcinogenesis?

“…Bacciu et al reported 26 temporal bone carcinomas (57.8%) on the right side and 19 (42.2%) on the left side . Shiga et al reported that 9 patients had EACSCC on the right side, and 5 had EACSCC on the left side . On the contrary, Gidley et al reported left dominance (55%) and concluded that SCC in the temporal bone was more commonly found on the left ear of middle‐aged to elderly men .…”

Concurrent necrotising otitis externa and adenocarcinoma of the temporal bone: a diagnostic challenge

“…Surgical resection can be difficult owing to complex regional anatomy and can often result in damage to the facial nerve and hearing loss 11. Metastatic adenocarcinoma of the temporal bone from a primary in the lung presenting with cranial nerve palsy has been described 12.…”