Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal

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.

DOI: 10.4103/0971-5851.166734

Cite this paper

@inproceedings{Joshi2015NeoadjuvantCI, title={Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal}, author={Amit Joshi and Nidhi Tandon and Vanita Noronha and Sachin Dhumal and Vijay Maruti Patil and Supreeta Arya and Shashikant L. Juvekar and Jaiprakash P. Agarwal and Anil K. Dcruz and Prathmesh S. Pai and Kumar Prabhash}, booktitle={Indian journal of medical and paediatric oncology : official journal of Indian Society of Medical & Paediatric Oncology}, year={2015} }