Nabuurs Cindy H, Kievit Wietske, Leemans Charles René Reinier, Smit Conrad F G M, van den Brekel Michiel W M, Pauw Robert J, van der Laan Bernard F A M, Jansen Jeroen C, Lacko Martin, Braunius Weibel W, Dai Chunfu, Shi Xunbei, Danesi Giovanni, Bouček Jan, Borsetto Daniele, Gowrishankar Shavran, Kania Romain, Jourdaine Clément, Jansen Thijs T G, Derks Jolanda, Dijkema Tim, Takes Robert P, Kunst Henricus Dirk P M
Department of Otorhinolaryngology and Head and Neck Surgery-Academic Alliance Skull Base Pathology Radboudumc & MUMC+, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
Rare Cancers, Radboud Institute for Health Sciences, 6525 EZ Nijmegen, The Netherlands.
Cancers (Basel). 2024 Nov 30;16(23):4026. doi: 10.3390/cancers16234026.
There is no consensus regarding the indication for postoperative radiotherapy (PORT) for T1- and T2-classified squamous cell carcinoma (SCC) of the external auditory canal (EAC) even with negative surgical margins. This study aimed to evaluate whether PORT provides additional benefits for these cases.
We collected retrospective data from fourteen international hospitals, including resected pT1- and pT2-classified EAC SCC with negative surgical margins.
A total of 112 early-stage radically resected EAC SCC were included, with 48 patients receiving PORT. The 5-year DFS of T1- and T2-classified EAC SCC treated with PORT was not statistically significantly different (92.9% and 76.9%, respectively) compared to the group treated without PORT (100% and 90.9%, respectively; -values of 0.999 and 0.526, respectively). EAC SCC treated with PORT more frequently exhibited perineural and angioinvasive growth. Eighteen patients experienced side effects related to radiotherapy, of which one patient developed osteoradionecrosis.
Our study suggests that PORT for early-stage radically resected EAC SCC should only be considered in selected cases with perineural, infiltrative growth or angioinvasive growth, and with a close margin. This approach helps mitigate the negative impact on quality of life and the risk of side effects associated with radiotherapy.
对于T1和T2期外耳道鳞状细胞癌（SCC），即使手术切缘阴性，术后放疗（PORT）的适应证也尚无共识。本研究旨在评估PORT对这些病例是否有额外益处。
我们收集了14家国际医院的回顾性数据，包括手术切缘阴性的pT1和pT2期外耳道SCC切除术患者。
共纳入112例早期行根治性切除术的外耳道SCC患者，其中48例接受了PORT。PORT治疗的T1和T2期外耳道SCC的5年无病生存率（DFS）与未接受PORT治疗的组（分别为100%和90.9%）相比，差异无统计学意义（分别为92.9%和76.9%；P值分别为0.999和0.526）。接受PORT治疗的外耳道SCC更常表现为神经周围和血管浸润性生长。18例患者出现与放疗相关的副作用，其中1例发生放射性骨坏死。
我们的研究表明，对于早期行根治性切除术的外耳道SCC，PORT仅应在有神经周围、浸润性生长或血管浸润性生长且切缘接近的特定病例中考虑。这种方法有助于减轻对生活质量的负面影响以及与放疗相关的副作用风险。
