Wang Jing, Xie Bingbin, Dai Chunfu
Department of Otology and Skull Base Surgery, Eye and ENT Hospital, Fudan University, Shanghai, China.
Otol Neurotol. 2015 Jul;36(6):1081-8. doi: 10.1097/MAO.0000000000000739.
To describe the clinical characteristics and management of patients with external auditory canal (EAC) squamous cell carcinoma (SCC) that arose after they received radiotherapy for nasopharyngeal carcinoma (NPC) and to compare them with primary EAC SCC patients.
Retrospective clinical analysis.
Hospital.
Nine irradiated NPC patients who subsequently developed secondary EAC SCC and 41 primary EAC SCC patients at a single hospital.
Clinical characteristics and management outcomes of patients were reviewed.
Clinical manifestations, regions of tumor involvement, the pathological staging, cumulative overall survival rates, Kaplan-Meier method, log rank test, and Mann-Whitney U test.
The most common symptoms of both groups were otorrhea, otalgia, and hearing loss. The region most involved in both groups was the EAC. The proportions of early stage (T1,T2) tumors in the post-irradiated and primary EAC SCC group were 56 and 22%, respectively. The 6-month, 1-year, 2-year, and 3-year cumulative overall survival rates of the post-irradiated EAC SCC group were 100, 100, 89, and 89%, respectively. The incidence of radionecrosis was higher in the post-irradiation EAC SCC group than in the primary EAC SCC group.
Post-irradiation EAC SCC has similar symptoms and invades similar regions as primary EAC SCC. The proportion of early stage tumors in the post-irradiated EAC SCC group was higher than that in the primary EAC SCC group. High incidence of radionecrosis was observed after the second course of radiotherapy. Aggressive surgical treatment is strongly recommended, but adjuvant radiotherapy for early stage EAC SCC should be provided cautiously.
描述鼻咽癌（NPC）放疗后发生外耳道（EAC）鳞状细胞癌（SCC）患者的临床特征及治疗情况，并与原发性EAC SCC患者进行比较。
回顾性临床分析。
医院。
一家医院的9例接受过放疗的NPC患者，这些患者随后发生继发性EAC SCC，以及41例原发性EAC SCC患者。
回顾患者的临床特征及治疗结果。
临床表现、肿瘤累及区域、病理分期、累积总生存率、Kaplan-Meier法、对数秩检验和Mann-Whitney U检验。
两组最常见的症状均为耳漏、耳痛和听力丧失。两组中最常受累的区域均为EAC。放疗后EAC SCC组和原发性EAC SCC组早期（T1、T2）肿瘤的比例分别为56%和22%。放疗后EAC SCC组6个月、1年、2年和3年的累积总生存率分别为100%、100%、89%和89%。放疗后EAC SCC组放射性坏死的发生率高于原发性EAC SCC组。
放疗后EAC SCC与原发性EAC SCC具有相似的症状和侵袭区域。放疗后EAC SCC组早期肿瘤的比例高于原发性EAC SCC组。第二次放疗后观察到放射性坏死的高发生率。强烈建议积极进行手术治疗，但对于早期EAC SCC应谨慎给予辅助放疗。
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