2023 Volume 163 Pages 104-111
At our department, we often treat patients with squamous cell carcinoma of the external auditory canal. One of the treatment transitions in the last two decades was the introduction of intra-arterial cisplatin and concurrent radiation therapy (RADPLAT) for organ preservation in 2003. We investigated the treatment outcomes according to the treatment period classified into two terms: 1975–2002 (previous period) and 2003–2018 (late period), and according to the treatment method adopted. The 5-year local control (LC), disease free survival (DFS), and overall survival (OS) rates were 59.1%, 51.8%, and 51.8% in the patients treated in the previous period, and 58.8%, 50.2%, and 64.0% in the patients treated in the late period, respectively. In addition, the 5-yr LC, DFS, and OS rates were 54.2%, 51.6%, and 51.0%, respectively, in the patients treated by surgery, and 51.5%, 44.6%, and 62.1%, respectively, in the patients who received RADPLAT. In patients with local early-stage disease (T1/T2), the 5-yr LC, DFS, and OS rates were 100%, 88.9%, and 88.9%, respectively, in the surgery group, and 66.7%, 66.7%, and 83.3%, respectively, in the RADPLAT group. In patients with locally advanced disease (T3/T4), the 5-yr LC, DFS, and OS rates were 25.0%, 25.0%, and 25.0%, respectively, in the surgery group, and 41.2%, 29.4%, and 47.1%, respectively, in the RADPLAT group. The group treated in the late period showed a more favorable OS rate than the group treated in the previous period, although the difference was not statistically significant. RADPLAT might be a more useful treatment modality for patients with locally advanced tumors as compared to surgery. However, for patients with local early-stage tumors, selection between surgical treatment and RADPLAT should be discussed.
