Concomitant Chemoradiotherapy as a Standard Treatment for Squamous Cell Carcinoma of the Temporal Bone

ABSTRACT

We sought to characterize the effectiveness of concomitant chemoradiotherapy (CCRT) for patients with squamous cell carcinoma of the temporal bone. We performed a retrospective chart review of 14 patients with cancer of the temporal bone who were provided initial treatment in our hospital from December 2001 to November 2008. Four patients with stage I tumors were treated by radiation therapy alone or with oral administration of S1. One patient with a stage II tumor was treated by radiation therapy concomitant with low dose docetaxel. Nine patients with stage IV tumors were treated by CCRT using the TPF regimen (docetaxel, cisplatin, and 5-fluorouracil). As an initial treatment, all patients but one were treated by radiation therapy with or without chemotherapy. Grade 4 adverse events of patients who received CCRT using the TPF regimen involved the leukopenia in one patient and the neutropenia in two patients. Local recurrences were observed in three patients including two patients with T4 tumors. Five-year disease-specific survival rates for all patients and for patients with T4 tumors were 78% and 67%, respectively. CCRT using the TPF regimen is safe and effective as the first treatment for patients with cancer of the temporal bone.

KEYWORDS

Squamous cell carcinoma of the temporal bone - chemoradiotherapy - TPF - survival rates

REFERENCES

• 1 Arriaga M, Curtin H, Takahashi H, Hirsch B E, Kamerer D B. Staging proposal for external auditory meatus carcinoma based on preoperative clinical examination and computed tomography findings.  Ann Otol Rhinol Laryngol. 1990;  99 (9 Pt 1) 714-721
• 2 Niibe Y, Nakayama M, Matsubayashi T et al.. Effectiveness of concurrent radiation therapy with UFT or TS-1 for T2N0 glottic cancer in Japan.  Anticancer Res. 2007;  27 (5B) 3497-3500
• 3 Akimoto T, Nonaka T, Kitamoto Y et al.. Radiation therapy for T2N0 laryngeal cancer: a retrospective analysis for the impact of concurrent chemotherapy on local control.  Int J Radiat Oncol Biol Phys. 2006;  64 995-1001
• 4 Schrijvers D, Vermorken J B. Role of taxoids in head and neck cancer.  Oncologist. 2000;  5 199-208
• 5 Katori H, Tsukuda M. Comparison of induction chemotherapy with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by radiation vs concurrent chemoradiotherapy with TPF in patients with locally advanced squamous cell carcinoma of the head and neck.  Clin Oncol (R Coll Radiol). 2005;  17 148-152
• 6 Posner M, Vermoke J B. Induction therapy in the modern era of combined-modality therapy for locally advanced head and neck cancer.  Semin Oncol. 2008;  35 221-228
• 7 Vermorken J B, Remenar E, van Herpen C EORTC 24971/TAX 323 Study Group et al. Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer.  N Engl J Med. 2007;  357 1695-1704
• 8 Lewis J S, Page R. Radical surgery for malignant tumors of the ear.  Arch Otolaryngol. 1966;  83 114-119
• 9 Prasad S, Janecka I P. Efficacy of surgical treatments for squamous cell carcinoma of the temporal bone: a literature review.  Otolaryngol Head Neck Surg. 1994;  110 270-280
• 10 Austin J R, Stewart K L, Fawzi N. Squamous cell carcinoma of the external auditory canal. Therapeutic prognosis based on a proposed staging system.  Arch Otolaryngol Head Neck Surg. 1994;  120 1228-1232
• 11 Zhang B, Tu G, Xu G, Tang P, Hu Y. Squamous cell carcinoma of temporal bone: reported on 33 patients.  Head Neck. 1999;  21 461-466
• 12 Gillespie M B, Francis H W, Chee N, Eisele D W. Squamous cell carcinoma of the temporal bone: a radiographic-pathologic correlation.  Arch Otolaryngol Head Neck Surg. 2001;  127 803-807
• 13 Nyrop M, Grøntved A. Cancer of the external auditory canal.  Arch Otolaryngol Head Neck Surg. 2002;  128 834-837
• 14 Moffat D A, Wagstaff S A, Hardy D G. The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone.  Laryngoscope. 2005;  115 341-347
• 15 Nakagawa T, Kumamoto Y, Natori Y et al.. Squamous cell carcinoma of the external auditory canal and middle ear: an operation combined with preoperative chemoradiotherapy and a free surgical margin.  Otol Neurotol. 2006;  27 242-248 discussion 249
• 16 Kunst H, Lavieille J-P, Marres H. Squamous cell carcinoma of the temporal bone: results and management.  Otol Neurotol. 2008;  29 549-552