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• W2056599474 abstract "Purpose/Objective(s)To report outcome of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated in our institution.Materials/MethodsA retrospective review was conducted of the records of 16 patients with SCC of the EAC and middle ear between July 2003 and March 2011. The median age of patients was 62 years (range: 41-76 years). We used the tumor staging system devised by Stell, and the node and metastases staging devised by the Union International Contre le Cancer (UICC). There were two T1, four T2, and 10 T3 tumors in our group. 14 patients were clinically N0, and 2 patients exhibited N1 disease. The treatment regimens of the patients were surgery and radiation therapy (RT) (n = 9), surgery and concurrent chemoradiation therapy (CRT) with intravenous cisplatin and fluorouracil (n =1), surgery and CRT with oral tegafur gimeracil oteracil potassium (n = 2), RT followed by surgery (n = 1), definitive RT (n = 2), and definitive CRT with oral tegafur gimeracil oteracil potassium and intravenous cisplatin (n = 1). After the surgery, intraparotid lymph node was found pathologically in the specimens of 2 patients in the clinical N0 group. The RT planning target volume included the primary tumor bed (n = 6), primary tumor (n = 2), and primary tumor/primary tumor bed with the lymph node area of the parotid, retroauricular, upper jugular, and upper accessory regions (n = 8). CT-guided treatment planning was performed in all patients. The median RT dose was 66 Gy (range: 50-70 Gy) at 2 Gy per fraction. Overall survival and progression-free survival rates were calculated according to the Kaplan-Meier method.ResultsThe median follow-up period was 24 months (range: 6-103 months). The median survival time was 25 months and the 2-year overall survival rate was 46%. The 1-year progression-free survival rate was 50%. Nine of 16 patients (56%) had recurrence. Six of the nine patients (67%) had in-field recurrence, two patients had in-field recurrence and regional lymph node metastasis, and one patient had in-field recurrence and distant lymph node metastasis. One patient who received definitive CRT including intravenous cisplatin had progression free for 33 months at the last day of follow up, although the stage was T3N1. One patient T2N0 but pathological N1 received surgery followed by CRT including intravenous cisplatin had progression free for 23 months at the last day of follow up.ConclusionsOur results demonstrate that high in-field recurrence rate of SCC of the EAC and middle ear even treated with surgery and high dose RT. To improve the treatment outcome of this radio-resistant tumor, our study suggest that concurrent chemoradiation therapy including cisplatin regimen may have benefit for overcoming SCC of the EAC and middle ear. Further prospective clinical trial is crucial to estimate the contribution. Purpose/Objective(s)To report outcome of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated in our institution. To report outcome of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated in our institution. Materials/MethodsA retrospective review was conducted of the records of 16 patients with SCC of the EAC and middle ear between July 2003 and March 2011. The median age of patients was 62 years (range: 41-76 years). We used the tumor staging system devised by Stell, and the node and metastases staging devised by the Union International Contre le Cancer (UICC). There were two T1, four T2, and 10 T3 tumors in our group. 14 patients were clinically N0, and 2 patients exhibited N1 disease. The treatment regimens of the patients were surgery and radiation therapy (RT) (n = 9), surgery and concurrent chemoradiation therapy (CRT) with intravenous cisplatin and fluorouracil (n =1), surgery and CRT with oral tegafur gimeracil oteracil potassium (n = 2), RT followed by surgery (n = 1), definitive RT (n = 2), and definitive CRT with oral tegafur gimeracil oteracil potassium and intravenous cisplatin (n = 1). After the surgery, intraparotid lymph node was found pathologically in the specimens of 2 patients in the clinical N0 group. The RT planning target volume included the primary tumor bed (n = 6), primary tumor (n = 2), and primary tumor/primary tumor bed with the lymph node area of the parotid, retroauricular, upper jugular, and upper accessory regions (n = 8). CT-guided treatment planning was performed in all patients. The median RT dose was 66 Gy (range: 50-70 Gy) at 2 Gy per fraction. Overall survival and progression-free survival rates were calculated according to the Kaplan-Meier method. A retrospective review was conducted of the records of 16 patients with SCC of the EAC and middle ear between July 2003 and March 2011. The median age of patients was 62 years (range: 41-76 years). We used the tumor staging system devised by Stell, and the node and metastases staging devised by the Union International Contre le Cancer (UICC). There were two T1, four T2, and 10 T3 tumors in our group. 14 patients were clinically N0, and 2 patients exhibited N1 disease. The treatment regimens of the patients were surgery and radiation therapy (RT) (n = 9), surgery and concurrent chemoradiation therapy (CRT) with intravenous cisplatin and fluorouracil (n =1), surgery and CRT with oral tegafur gimeracil oteracil potassium (n = 2), RT followed by surgery (n = 1), definitive RT (n = 2), and definitive CRT with oral tegafur gimeracil oteracil potassium and intravenous cisplatin (n = 1). After the surgery, intraparotid lymph node was found pathologically in the specimens of 2 patients in the clinical N0 group. The RT planning target volume included the primary tumor bed (n = 6), primary tumor (n = 2), and primary tumor/primary tumor bed with the lymph node area of the parotid, retroauricular, upper jugular, and upper accessory regions (n = 8). CT-guided treatment planning was performed in all patients. The median RT dose was 66 Gy (range: 50-70 Gy) at 2 Gy per fraction. Overall survival and progression-free survival rates were calculated according to the Kaplan-Meier method. ResultsThe median follow-up period was 24 months (range: 6-103 months). The median survival time was 25 months and the 2-year overall survival rate was 46%. The 1-year progression-free survival rate was 50%. Nine of 16 patients (56%) had recurrence. Six of the nine patients (67%) had in-field recurrence, two patients had in-field recurrence and regional lymph node metastasis, and one patient had in-field recurrence and distant lymph node metastasis. One patient who received definitive CRT including intravenous cisplatin had progression free for 33 months at the last day of follow up, although the stage was T3N1. One patient T2N0 but pathological N1 received surgery followed by CRT including intravenous cisplatin had progression free for 23 months at the last day of follow up. The median follow-up period was 24 months (range: 6-103 months). The median survival time was 25 months and the 2-year overall survival rate was 46%. The 1-year progression-free survival rate was 50%. Nine of 16 patients (56%) had recurrence. Six of the nine patients (67%) had in-field recurrence, two patients had in-field recurrence and regional lymph node metastasis, and one patient had in-field recurrence and distant lymph node metastasis. One patient who received definitive CRT including intravenous cisplatin had progression free for 33 months at the last day of follow up, although the stage was T3N1. One patient T2N0 but pathological N1 received surgery followed by CRT including intravenous cisplatin had progression free for 23 months at the last day of follow up. ConclusionsOur results demonstrate that high in-field recurrence rate of SCC of the EAC and middle ear even treated with surgery and high dose RT. To improve the treatment outcome of this radio-resistant tumor, our study suggest that concurrent chemoradiation therapy including cisplatin regimen may have benefit for overcoming SCC of the EAC and middle ear. Further prospective clinical trial is crucial to estimate the contribution. Our results demonstrate that high in-field recurrence rate of SCC of the EAC and middle ear even treated with surgery and high dose RT. To improve the treatment outcome of this radio-resistant tumor, our study suggest that concurrent chemoradiation therapy including cisplatin regimen may have benefit for overcoming SCC of the EAC and middle ear. Further prospective clinical trial is crucial to estimate the contribution." @default.
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• W2056599474 date "2012-11-01" @default.
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• W2056599474 title "The Treatment Outcome of Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear: A Single Institution Experience" @default.
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• W2056599474 doi "https://doi.org/10.1016/j.ijrobp.2012.07.1393" @default.
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