Hypofractionated Stereotactic Radiotherapy for Auditory Canal or Middle Ear Cancer

Author:

Murai Taro12,Kamata Shin-Etsu34,Sato Kengo25,Miura Kouki4,Inoue Mitsuhiro5,Yokota Naoki26,Ohta Seiji2,Iwabuchi Michio2,Iwata Hiromitsu7,Shibamoto Yuta1

Affiliation:

1. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

2. Yokohama CyberKnife Center, Yokohama, Japan

3. Head and Neck Tumor Center Chiba Tokushukai Hospital, Funabashi, Japan

4. Department of Head and Neck Oncology and Surgery, International University of Health and Welfare Mita Hospital, Tokyo, Japan,

5. Department of Neurosurgery, Japanese Red Cross Medical Center, Tokyo, Japan

6. Radiation Oncology Center, Suzukake Central Hospital, Hamamatsu, Shizuoka, Japan,

7. Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City West Medical Center, Nagoya, Japan.

Abstract

Background Stereotactic radiotherapy (SRT) may represent a new treatment option for individuals with auditory canal or middle ear cancer. Methods Study participants with pathologically proven ear cancer were treated with SRT (35 Gy for 3 fractions or 40 Gy for 5 fractions) as first-line therapy. When local tumor recurrence developed following SRT, subtotal temporal bone resection and postoperative chemoradiotherapy were performed as salvage treatment. Boluses were used for the initial 14 study patients. Results Twenty-nine study participants were enrolled and staged with T1 (n = 3), T2 (n = 7), T3 (n = 14), or T4 disease (n = 5). Three-year overall survival rates were 69% for T1/2 disease, 79% for T3 disease, and 0% for T4 disease. Three-year local control rates were 70% for T1/2 disease, 50% for T3 disease, and 20% for T4 disease. Grade 2 or higher dermatitis or soft-tissue necrosis occurred more frequently in study patients treated with boluses (8/14 vs 2/15; P = .02). Salvage treatment was safely performed for 12 recurrent cases. Conclusions These results suggest that SRT outcomes are promising for patients with ear cancer (≤ T3 disease). The rate of toxicity was acceptable in the study patients treated without boluses. Outcomes of salvage surgery and postoperative radiotherapy following SRT were also encouraging.

Publisher

SAGE Publications

Subject

Oncology,Hematology,General Medicine

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