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Indian J Med Paediatr Oncol. 2015 Jul-Sep;36(3):172-5. doi: 10.4103/0971-5851.166734.

Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal.

Indian journal of medical and paediatric oncology : official journal of Indian Society of Medical & Paediatric Oncology

Amit Joshi, Nidhi Tandon, Vanita Noronha, Sachin Dhumal, Vijay Patil, Supreeta Arya, Shashikant Juvekar, Jaiprakash Agarwal, Anil DCruz, Prathmesh Pai, Kumar Prabhash

Affiliations

  1. Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
  2. Department of Radiology, Tata Memorial Centre, Mumbai, Maharashtra, India.
  3. Department of Radio-diagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India.
  4. Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.

PMID: 26855526 PMCID: PMC4743187 DOI: 10.4103/0971-5851.166734

Abstract

BACKGROUND: Carcinoma of external auditory canal (EAC) is a very rare malignancy with surgical resection as the main modality of treatment. The outcomes with nonsurgical modalities are very dismal. We present a retrospective analysis of 4 patients evaluating the role of neoadjuvant chemotherapy in technically unresectable cancers.

MATERIALS AND METHODS: This is a retrospective analysis of 4 patients from our institute from 2010 to 2014 with carcinoma EAC who were deemed unfit for surgery due to extensive disease involving occipital bone with soft tissue infiltration (n = 2), temporal dura (n = 1), left temporal lobe, and extensive soft tissue involvement (n = 1). All these patients received neoadjuvant chemotherapy with docetaxel, cisplatin and 5 fluorouracil (n = 3) and paclitaxel and cisplatin (n = 1).

RESULTS: Response evaluation showed a partial response (PR) in 3 and stable disease (SD) in 1 patient by Response Evaluation Criteria in Solid Tumors criteria. All 3 patients who received 3 drug chemotherapy had PR while 1 patient who received 2 drug chemotherapy had SD. Two of these patients underwent surgery, and other 2 underwent definitive chemoradiation. One of 3 patients who achieved PR underwent surgical resection; the other 2 remained unresectable in view of the persistent intradural extension and infratemporal fossa involvement. One patient who had SD could undergo surgery in view of clearance of infraatemporal fossa. Recent follow-up shows that 3 out of these 4 patients are alive.

CONCLUSION: This indicates that there may be a role of induction chemotherapy in converting potentially unresectable tumors to resectable disease that could produce better outcomes in carcinoma EAC.

Keywords: Carcinoma of external auditory canal; neoadjuvant chemotherapy; unresectable

References

  1. J Med Assoc Thai. 2005 Jan;88(1):114-7 - PubMed
  2. Laryngoscope. 1960 May;70:551-79 - PubMed
  3. Arch Otolaryngol. 1974 Jul;100(1):45-9 - PubMed
  4. Chemother Res Pract. 2014;2014:487872 - PubMed
  5. N Engl J Med. 2007 Oct 25;357(17):1695-704 - PubMed
  6. N Engl J Med. 2007 Oct 25;357(17):1705-15 - PubMed
  7. Am J Otol. 1996 May;17(3):438-42 - PubMed
  8. Oral Oncol. 2014 Oct;50(10):1000-4 - PubMed
  9. J Laryngol Otol. 1965 Feb;79:85-119 - PubMed
  10. Int J Radiat Oncol Biol Phys. 1990 Mar;18(3):631-3 - PubMed
  11. Otolaryngol Head Neck Surg. 1991 Jan;104(1):58-66 - PubMed
  12. Cancer. 1987 Jan 1;59(1):156-60 - PubMed
  13. J Clin Oncol. 2003 Jan 15;21(2):327-33 - PubMed
  14. Otolaryngol Clin North Am. 2001 Dec;34(6):1197-218, x - PubMed
  15. Ugeskr Laeger. 1995 Apr 10;157(15):2139-42 - PubMed
  16. Am J Otol. 1998 Nov;19(6 Suppl):S1-15 - PubMed
  17. Indian J Cancer. 2014 Apr-Jun;51(2):100-3 - PubMed

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