J Korean Soc Ther Radiol Oncol.  2009 Dec;27(4):173-180. 10.3857/jkstro.2009.27.4.173.

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

Affiliations
  • 1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. wuhg@snu.ac.kr
  • 2Department of Otolaryngology and Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 4Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 5Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.

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.

Keyword

Ear canal; Middle ear; Squamous cell carcinoma; Radiotherapy

MeSH Terms

Carcinoma, Squamous Cell
Ear Canal
Ear, Middle
Follow-Up Studies
Humans
Retrospective Studies
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