A retrospective analysis of radiotherapy in the treatment of external auditory canal carcinoma

Katano, Atsuto; Takenaka, Ryousuke; Yamashita, Hideomi; Ando, Mizuo; Yoshida, Masafumi; Saito, Yuki; Asakage, Takahiro; Abe, Osamu; Nakagawa, Keiichi

doi:10.3892/mco.2021.2207

Cited by 6 publications

(5 citation statements)

References 21 publications

(23 reference statements)

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“…There are no prospective or randomized trials about EAC cancer treatment, and there is no clear consensus about treatment strategies, especially in advanced cases. A retrospective study done in Japan showed similar 5-year overall survival in those treated with definitive radiotherapy compared with surgically treated patients [ 8 ]. Outcomes of definitive radiotherapy for EAC SCC was reported by Pemberton et al, wherein they delivered 55 Gy in 20 fractions of RT.…”

Section: Discussionmentioning

confidence: 99%

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report

Dumago¹,

Yu²,

Jacomina³

et al. 2023

jcb

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Purpose To report technical details and 15-month outcomes of a patient with node-positive external auditory canal (EAC) squamous cell carcinoma (SCC) treated with definitive intracavitary high-dose-rate (HDR) brachytherapy to primary tumor, and external beam radiotherapy (EBRT) to draining lymphatics. Material and methods A 21-year-old male was diagnosed with SCC of the right EAC. The patient underwent definitive HDR intracavitary brachytherapy, 340 cGy/fraction for 14 twice-daily fractions, followed by EBRT using intensity-modulated radiation therapy (IMRT) to cover the grossly enlarged pre-auricular node, ipsilateral intra-parotid, and cervical lymph node levels II and III. Results The approved brachytherapy plan had an average high-risk clinical tumor volume (CTV-HR) D 90 of 341 cGy with a total dose of 47.7 Gy (BED, 80.3 Gy, EQD 2 , 66.6 Gy). For the approved IMRT plan, the prescription to the involved right pre-auricular node was 66 Gy in 33 fractions, and more than 95% of the target received at least 62.7 Gy. High-risk nodal regions were simultaneously prescribed: 59.4 Gy in 1.8 Gy fractions, and more than 95% received at least 56.4 Gy. Organs at risk (OARs) were kept below their dose constraints. The patient tolerated both the procedures with no grade ≥ 2 treatment-related adverse events. Grade 1 dermatitis in the right pre-auricular and cervical areas during the course of EBRT was experienced. Fifteen months post-RT, the patient has no evidence of disease, and was noted to have EAC stenosis, which translated to moderate conductive hearing loss of the right ear. Thyroid function was normal at 15 months after EBRT. Conclusions This case report illustrates that the delivered definitive radiotherapy is technically feasible, effective, and well-tolerated in patients with SCC of EAC.

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Section: Discussionmentioning

confidence: 99%

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report

Dumago¹,

Yu²,

Jacomina³

et al. 2023

jcb

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“…The importance of adjuvant radiotherapy and chemotherapy usually varies in different tumor types. At present, surgical resection combined with adjuvant radiotherapy is a standard therapeutic regimen for EACC patients [6, [42][43][44], especially for advanced EACC patients [45][46][47]. Adjuvant radiotherapy is also recommended in some early-stage EACC patients with some risk factors, such as positive surgical margin, parotid gland invasion, bone invasion, and peripheral nerve invasion [2,33,35,48].…”

Section: Discussionmentioning

confidence: 99%

Nutrition-immune-inflammation score (NIIS) plays an important role in the prognosis of postoperative external auditory canal carcinoma patients

Cheng,

Xu,

et al. 2023

Preprint

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Background External auditory canal carcinoma (EACC) was a rare malignant tumor. This study aimed to investigate the influence of the comprehensive index of nutrition-immune-inflammation score (NIIS) on the prognosis of EACC patients with surgical resection. Methods A total of 45 EACC patients with surgical resection were selected from two tertiary medical institutions, and were diagnosed between July 2012 and May 2018. NIIS was calculated by integrating the values of body mass index (BMI), C-reactive protein (CRP), lymphocytes, albumin, and hemoglobin. The relationship between NIIS and prognosis was analyzed by a Log-rank test and displayed by Kaplan-Meier plot. Result The 3- and 5-year survival rate for EACC patients with surgical resection were 70.7%, 61.3% for OS, and 55.6%, 51.1% for PFS, respectively. Most patients with EACC have a nutrition-immune-inflammation score (NIIS) of 4–5 (44.4%). EACC patients with a high score of NIIS tend to have poorer OS (P = 0.001) and PFS (P < 0.001) in comparison with a low score of NIIS. Only a small minority of patients with EACC accept adjuvant radiotherapy (37.8%), and adjuvant chemotherapy (15.6%). Adjuvant radiotherapy had benefit in improving the OS for EACC patients with surgical resection (P = 0.027). However, the adjuvant treatment had no benefit for PFS in postoperative EACC patients (P > 0.05). Conclusion NIIS is an important predictor for predicting the prognosis of EACC patients with surgical resection. Adjuvant radiotherapy was recommended in the application of EACC patients with surgical resection, but not adjuvant chemotherapy. Our findings would have a vital effect on treatment choice and clinical management for both EACC patients and clinicians.

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“…Several studies on treatment strategies for EAC cancer concluded that a combination treatment of surgery and postoperative radiation was the most curative for T2–3 disease [ 3 , 5 , 6 , 17 , 18 ]. However, adverse events from surgery are not uncommon [ 3 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Radiotherapy without Surgery for External Auditory Canal Squamous Cell Carcinoma

Osu

Saitoh

Yumisaki

et al. 2022

JCM

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External auditory canal (EAC) cancer is a rare disease for which there are no adequate evidence-based treatment strategies. Radiotherapy is often used as the initial treatment to preserve the organ. This study aimed to elucidate the efficacy of radiotherapy for EAC squamous cell carcinoma (SCC). Patients with T1 disease were treated with radiotherapy alone. Patients with T2-4 disease were treated with chemoradiotherapy. The median follow-up period was 30.4 months. The 3-year local control (LC) rate for all patients was 51%, the disease-free survival (DFS) rate was 44%, and the overall survival (OS) rate was 73%. For T1-3 disease, the 3-year LC rate was 74%, DFS was 62%, and OS was 89%. However, for T4 disease, the 3-year LC rate was 17%, DFS was 17%, and OS was 50%. In a univariate analysis, only the T-category was a significant factor for LC and DFS (p = 0.006 and 0.02, respectively). All local recurrences were within the high-dose irradiated area. The results of this study suggest chemoradiotherapy can be an alternative to a combination of surgery and postoperative radiation for T1-3 SCC of the EAC. However, the efficacy of chemoradiotherapy in T4 cases was inadequate.

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A retrospective analysis of radiotherapy in the treatment of external auditory canal carcinoma

Cited by 6 publications

References 21 publications

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report

Nutrition-immune-inflammation score (NIIS) plays an important role in the prognosis of postoperative external auditory canal carcinoma patients

The Efficacy of Radiotherapy without Surgery for External Auditory Canal Squamous Cell Carcinoma

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