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J Korean Soc Ther Radiol Oncol > Volume 27(4); 2009 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2009;27(4): 173-180. doi: https://doi.org/10.3857/jkstro.2009.27.4.173
Role of Radiotherapy for Squamous Cell Carcinoma of the External Auditory Canal and Middle Ear
Hyun Cheol Kang, Hong Gyun Wu, Ji Hye Lee, Charn Il Park, Chong Sun Kim, Seung Ha Oh, Dae Seog Heo, Dong Wan Kim, Se Hoon Lee
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.
To investigate the role of radiotherapy for squamous cell carcinomas of the external auditory canal and middle ear.
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).
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.
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.
Key Words: Ear canal, Middle ear, Squamous cell carcinoma, Radiotherapy
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