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

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

Authors:
- Atsuto Katano
- Ryousuke Takenaka
- Hideomi Yamashita
- Mizuo Ando
- Masafumi Yoshida
- Yuki Saito
- Takahiro Asakage
- Osamu Abe
- Keiichi Nakagawa
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Affiliations: Department of Radiology, The University of Tokyo Hospital, Bunkyo‑ku, Tokyo 113‑8655, Japan, Department of Otolaryngology, The University of Tokyo Hospital, Bunkyo‑ku, Tokyo 113‑8655, Japan, Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo 113‑8510, Japan
Published online on: January 13, 2021 https://doi.org/10.3892/mco.2021.2207
Article Number: 45

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Abstract

External auditory canal carcinoma (EACC) is a rare disease. The current study aimed to evaluate the clinical outcomes of patients treated with external beam radiotherapy (EBRT) for EACC. The present study retrospectively reviewed 34 consecutive patients treated for EACC with EBRT between February 2001 and January 2019 at the University of Tokyo Hospital. Clinical staging was performed according to the modified Pittsburgh classification. Of all the included patients, seven patients were in the early stages (I or II) and 27 in the advanced stages (III or IV) of EACC. A total of 16 patients underwent EBRT and surgery (S+RT) pre‑ and/or postoperatively, while 18 patients underwent definitive radiotherapy (dRT). The median prescribed doses for the S+RT and dRT groups were 66 and 70 Gy, respectively. The median follow‑up period for all patients was 22.4 months (range, 2‑205 months). The 5‑year overall survival rates of the S+RT and dRT groups were 66.7 and 45.1%, respectively. The progression‑free survival rate at 5‑year was 55.6% (95% confidence interval: 36.5‑71.1%) for the entire cohort. A total of 14 patients experienced disease relapse after treatment, consisting of 11 locoregional recurrences and three distant metastases. The current study revealed the clinical outcomes of EBRT for EACC.

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1	Kuhel WI, Hume CR and Selesnick SH: Cancer of the external auditory canal and temporal bone. Otolaryngol Clin North Am. 29:827–852. 1996.PubMed/NCBI
2	Nyrop M and Grøntved A: Cancer of the external auditory canal. Arch Otolaryngol Head Neck Surg. 128:834–837. 2002.PubMed/NCBI View Article : Google Scholar
3	Tsunoda A, Sumi T, Terasaki O and Kishimoto S: Right dominance in the incidence of external auditory canal squamous cell carcinoma in the Japanese population: Does handedness affect carcinogenesis? Laryngoscope Investig Otolaryngol. 2:19–22. 2017.PubMed/NCBI View Article : Google Scholar
4	Devaney KO, Boschman CR, Willard SC, Ferlito A and Rinaldo A: Tumours of the external ear and temporal bone. Lancet Oncol. 6:411–420. 2005.PubMed/NCBI View Article : Google Scholar
5	Stell PM and McCormick MS: Carcinoma of the external auditory meatus and middle ear Prognostic factors and a suggested staging system. J Laryngol Otol. 99:847–850. 1985.PubMed/NCBI View Article : Google Scholar
6	Moody SA, Hirsch BE and Myers EN: Squamous cell carcinoma of the external auditory canal: An evaluation of a staging system. Am J Otol. 21:582–588. 2000.PubMed/NCBI
7	Arriaga M, Curtin H, Takahashi H, Hirsch BE and Kamerer DB: Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings. Ann Otol Rhinol Laryngol. 99:714–721. 1990.PubMed/NCBI View Article : Google Scholar
8	Morita S, Mizumachi T, Nakamaru Y, Sakashita T, Kano S, Hoshino K, Fukuda A, Fujiwara K and Homma A: Comparison of the university of pittsburgh staging system and the eighth edition of the american joint committee on Cancer TNM classification for the prognostic evaluation of external auditory canal cancer. Int J Clin Oncol. 23:1029–1037. 2018.PubMed/NCBI View Article : Google Scholar
9	Matoba T, Hanai N, Suzuki H, Nishikawa D, Tachibana E, Okada T, Murakami S and Hasegawa Y: Treatment and outcomes of carcinoma of the external and middle Ear: The validity of En bloc resection for advanced tumor. Neurol Med Chir (Tokyo). 58:32–38. 2018.PubMed/NCBI View Article : Google Scholar
10	Takenaka Y, Cho H, Nakahara S, Yamamoto Y, Yasui T and Inohara H: Chemoradiation therapy for squamous cell carcinoma of the external auditory canal: A meta-analysis. Head Neck. 37:1073–1080. 2015.PubMed/NCBI View Article : Google Scholar
11	Ogawa K, Nakamura K, Hatano K, Uno T, Fuwa N, Itami J, Kojya S, Nakashima T, Shinhama A, Nakagawa T, et al: Treatment and prognosis of squamous cell carcinoma of the external auditory canal and middle ear: A multi-institutional retrospective review of 87 patients. Int J Radiat Oncol Biol Phys. 68:1326–1334. 2007.PubMed/NCBI View Article : Google Scholar
12	Bacciu A, Clemente IA, Piccirillo E, Ferrari S and Sanna M: Guidelines for treating temporal bone carcinoma based on long-term outcomes. Otol Neurotol. 34:898–907. 2013.PubMed/NCBI View Article : Google Scholar
13	Fleiner F, Jumah M and Göktas O: Cancer of the external auditory canal-diagnostic and treatment. Indian J Otolaryngol Head Neck Surg. 61:270–274. 2009.PubMed/NCBI View Article : Google Scholar
14	Pemberton LS, Swindell R and Sykes AJ: Primary radical radiotherapy for squamous cell carcinoma of the middle Ear and external auditory Cana-an historical series. Clin Oncol (R Coll Radiol). 18:390–394. 2006.PubMed/NCBI View Article : Google Scholar
15	Murai T, Kamata SE, Sato K, Miura K, Inoue M, Yokota N, Ohta S, Iwabuchi M, Iwata H and Shibamoto Y: Hypofractionated stereotactic radiotherapy for auditory canal or middle ear cancer. Cancer Control. 23:311–316. 2016.PubMed/NCBI View Article : Google Scholar
16	Shinomiya H, Hasegawa S, Yamashita D, Ejima Y, Kenji Y, Otsuki N, Kiyota N, Sakakibara S, Nomura T, Hashikawa K, et al: Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone. Head Neck. 38 (Suppl 1):E949–E953. 2016.PubMed/NCBI View Article : Google Scholar
17	Austin JR, Stewart KL and Fawzi N: Squamous cell carcinoma of the external auditory canal. Therapeutic prognosis based on a proposed staging system. Arch Otolaryngol Head Neck Surg. 120:1228–1232. 1994.PubMed/NCBI View Article : Google Scholar
18	Hahn SS, Kim JA, Goodchild N and Constable WC: Carcinoma of the middle ear and external auditory canal. Int J Radiat Oncol Biol Phys. 9:1003–1007. 1983.PubMed/NCBI View Article : Google Scholar
19	Nakagawa T, Kumamoto Y, Natori Y, Shiratsuchi H, Toh S, Kakazu Y, Shibata S, Nakashima T and Komune S: Squamous cell carcinoma of the external auditory canal and middle Ear: An operation combined with preoperative chemoradiotherapy and a free surgical margin. Otol Neurotol. 27:242–249. 2006.PubMed/NCBI View Article : Google Scholar
20	Choi J, Kim SH, Koh YW, Choi EC, Lee CG and Keum KC: Tumor stage-related role of radiotherapy in patients with an external auditory canal and middle Ear carcinoma. Cancer Res Treat. 49:178–184. 2017.PubMed/NCBI View Article : Google Scholar
21	Yoon M, Chougule P, Dufresne R and Wanebo HJ: Localized carcinoma of the external ear is an unrecognized aggressive disease with a high propensity for local regional recurrence. Am J Surg. 164:574–577. 1992.PubMed/NCBI View Article : Google Scholar
22	Hayashi K, Koto M, Demizu Y, Saitoh JI, Suefuji H, Okimoto T, Ohno T, Shioyama Y, Takagi R, Ikawa H, et al: A retrospective multicenter study of carbon-ion radiotherapy for external auditory canal and middle Ear carcinomas. Cancer Med. 8:51–57. 2019.PubMed/NCBI View Article : Google Scholar
23	Nagano T, Yoshimura RI, Kojima M, Nakagawa K and Toda K: Outcomes of radiotherapy in advanced external auditory canal cancer. J Radiat Res. 60:380–386. 2019.PubMed/NCBI View Article : Google Scholar
24	Sugimoto H, Ito M, Yoshida S, Hatano M and Yoshizaki T: Concurrent superselective intra-arterial chemotherapy and radiotherapy for late-stage squamous cell carcinoma of the temporal bone. Ann Otol Rhinol Laryngol. 120:372–376. 2011.PubMed/NCBI View Article : Google Scholar
25	Fujiwara M, Yamamoto S, Doi H, Takada Y, Odawara S, Niwa Y, Ishikura R, Kamikonya N, Terada T, Uwa N, et al: Arterial chemoradiotherapy for carcinomas of the external auditory canal and middle ear. Laryngoscope. 125:685–689. 2015.PubMed/NCBI View Article : Google Scholar