The Outcomes of Surgery and Chemoradiotherapy for Temporal Bone Cancer

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Abstract

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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