The Outcomes of Surgery and Chemoradiotherapy for Temporal Bone Cancer

OBJECTIVE:We aimed to evaluate the prognostic factors and efficacy of treatment modalities for patients with temporal bone cancer, and to determine if definitive chemoradiotherapy (CRT) for advanced-stage disease can provide a substitute for highly invasive surgeries. STUDY DESIGN:Retrospective case...

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Published in:Otology & neurotology Vol. 37; no. 8; pp. 1174 - 1182
Main Authors: Morita, Shinya, Homma, Akihiro, Nakamaru, Yuji, Sakashita, Tomohiro, Hatakeyama, Hiromitsu, Kano, Satoshi, Fukuda, Atsushi, Fukuda, Satoshi
Format: Journal Article
Language:English
Published: United States Copyright by Otology & Neurotology, Inc. Image copyright Wolters Kluwer Health/Anatomical Chart Company 01-09-2016
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Summary:OBJECTIVE:We aimed to evaluate the prognostic factors and efficacy of treatment modalities for patients with temporal bone cancer, and to determine if definitive chemoradiotherapy (CRT) for advanced-stage disease can provide a substitute for highly invasive surgeries. STUDY DESIGN:Retrospective case series. SETTING:Tertiary referral center. PATIENTS:Sixty-six patients with previously untreated squamous cell carcinoma of the temporal bone treated with curative intent between April 1997 and March 2015. INTERVENTION:Surgery alone, radiotherapy (RT) alone, surgery followed by RT or definitive CRT. MAIN OUTCOME MEASURE:The overall survival (OS) rate. RESULTS:The 5-year OS rate for each T classification was 100% for T1, 76.2% for T2, 55.6% for T3, and 36.7% for T4. Univariable and multivariable analysis showed that T classification was an independent predictor of the OS rate (hazard ratio 5.66; 95% confidence interval 1.51–27.0; p = 0.015). Analysis by treatment modality revealed that the 5-year OS rate for patients with T1–2 was 100% for surgery and 81.3% for RT alone. The rate for patients with T3–4 was 52.1% for definitive CRT and 55.6% for surgery followed by RT with or without chemotherapy. CONCLUSIONS:Patients with T1–2 benefited from surgical intervention without significant morbidity or mortality. Our findings also suggested that definitive CRT might be appropriate as the first-line treatment for T3–4, especially in cases with unresectable tumors.
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ISSN:1531-7129
1537-4505
DOI:10.1097/MAO.0000000000001152