Postoperative intensity-modulated radiotherapy for squamous cell carcinoma of the external auditory canal and middle ear: treatment outcomes, marginal misses, and perspective on target delineation
Autor: | Chun-Wei Wang, Sung-Hsin Kuo, Jason Chia-Hsien Cheng, Cheng-Ping Wang, Yu-Hsuan Chen, Kai-Nan Lin, Chiao-Ling Tsai, Pei-Jen Lou, Jenq-Yuh Ko, Fok-Ching Chong, Szu-Huai Lu, Ruey-Long Hong, Chuan-Jen Hsu, Wan-Yu Chen, Ya-Fang Chen |
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Rok vydání: | 2011 |
Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Ear Middle Ear neoplasm Radiotherapy Setup Errors Tegafur Rare Diseases medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Ear canal Radiation treatment planning Ear Neoplasms Aged Aged 80 and over Postoperative Care Radiation business.industry Middle Aged medicine.disease Surgery Temporomandibular joint Radiation therapy stomatognathic diseases medicine.anatomical_structure Treatment Outcome Oncology Middle ear Carcinoma Squamous Cell Female Radiotherapy Intensity-Modulated Neoplasm Recurrence Local business Ear Canal medicine.drug |
Zdroj: | International journal of radiation oncology, biology, physics. 82(4) |
ISSN: | 1879-355X |
Popis: | Purpose To report outcomes of the rare disease of squamous cell carcinoma (SCC) of the external auditory canal (EAC) and middle ear treated with surgery and postoperative intensity-modulated radiotherapy (IMRT). Failure patterns related to spatial dose distribution were also analyzed to provide insight into target delineation. Methods and Materials A retrospective review was conducted of the records of 11 consecutive patients with SCC of the EAC and middle ear who were treated with curative surgery and postoperative IMRT at one institution between January 2007 and February 2010. The prescribed IMRT dose was 60 to 66 Gy at 2 Gy per fraction. Three patients also received concurrent cisplatin-based chemotherapy, and 1 patient received concurrent oral tegafur/uracil. The median follow-up time was 19 months (range, 6–33 months). Results Four patients had locoregional recurrence, yielding an estimated 2-year locoregional control rate of 70.7%. Among them, 1 patient had persistent disease after treatment, and 3 had marginal recurrence. Distant metastasis occurred in 1 patient after extensive locoregional recurrence, yielding an estimated 2-year distant control rate of 85.7%. The estimated 2-year overall survival was 67.5%. The three cases of marginal recurrence were near the preauricular space and glenoid fossa of the temporomandibular joint, adjacent to the apex of the ear canal and glenoid fossa of the temporomandibular joint, and in the postauricular subcutaneous area and ipsilateral parotid nodes, respectively. Conclusions Marginal misses should be recognized to improve target delineation. When treating SCC of the EAC and middle ear, care should be taken to cover the glenoid fossa of the temporomandibular joint and periauricular soft tissue. Elective ipsilateral parotid irradiation should be considered. The treatment planning procedure should also be refined to balance subcutaneous soft-tissue dosimetry and toxicity. |
Databáze: | OpenAIRE |
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