Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear

Abstract

Purpose: To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear. Materials and Methods: A series of 35 patients who were treated at a single institution from 1981 through 2007 were retrospectively analyzed. Thirteen patients were treated by radiotherapy alone; four by surgery only and 18 by a combination of surgery and radiotherapy. The total radiation dose ranged from 39∼70 Gy (median, 66 Gy) in 13∼35 fractions for radiotherapy alone and 44∼70 Gy (median, 61.2 Gy) in 22∼37 fractions for the combined therapy. Clinical end-points were the cause of specific survival (CSS) and local relapse-free survival (LRFS). The median follow-up time was 2.8 years (range, 0.2∼14.6 years). Results: The 3-year CSS and LRFS rate was 80% and 63%, respectively. Based on a univariate analysis, performance status and residual disease after treatment had a significant impact on CSS; performance status and histologic grade for LRFS. Patients treated by radiotherapy alone had more residual disease following the course of treatment compared to patients treated with the combined therapy; 69% vs. 28%, respectively. Conclusion: Our results suggest that radiation alone was not an inferior treatment modality for CSS compared to the combined therapy for squamous cell carcinoma of the external auditory canal and middle ear. However, local failure after radiotherapy is the main issue that will require further improvement to gain optimal local control.

Tatalaksana karsinoma sel skuamosa kanalis akustikus eksternus

“…8 Pasien dengan riwayat kemoradiasi sebelumnya dan didapatkan perluasan massa pasca terapi berdasarkan Kang dkk. 9 tidak mendapatkan adanya perbedaan survival rate yang bermakna antara pasien-pasien karsinoma sel skuamosa KAE yang ditangani dengan radioterapi dan pembedahan dengan yang ditangani dengan radioterapi saja. Namun, kegagalan kontrol lokal lebih tinggi pada pasien yang menjalani radioterapi saja.…”

“…11 mendapatkan 5-years survival rate pada 10 pasien karsinoma sel skuamosa KAE dengan perluasan tumor T1 yang diterapi dengan radioterapi saja sebesar 83% dan 9 dari 10 pasien tersebut tidak menunjukkan kekambuhan lokal. 9 Penatalaksanaan pembedahan dilakukan terhadap 4 pasien kami. Pasien pertama ditatalaksana pembedahan yang meliputi debridement, debulking massa, dan rekonstruksi menggunakan PM Flap yang diambil dari muskulus pektoralis mayor dada kanan untuk menutup defek massa.…”