The Outcomes of Surgery and Chemoradiotherapy for Temporal Bone Cancer

Otol Neurotol. 2016 Sep;37(8):1174-82. doi: 10.1097/MAO.0000000000001152.

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.

MeSH terms

  • Adult
  • Aged
  • Bone Neoplasms / therapy*
  • Chemoradiotherapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Orthopedic Procedures
  • Retrospective Studies
  • Skull Neoplasms / therapy*
  • Survival Rate
  • Temporal Bone / pathology
  • Treatment Outcome