Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal

• Published in: Indian journal of medical and paediatric oncology Vol. 36; no. 3; pp. 172 - 175
• Main Authors: Joshi, Amit, Tandon, Nidhi, Noronha, Vanita, Dhumal, Sachin, Patil, Vijay, Arya, Supreeta, Juvekar, Shashikant, Agarwal, Jaiprakash, DCruz, Anil, Pai, Prathmesh, Prabhash, Kumar
• Format: Journal Article
• Language: English
• Published: A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.07.2015; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd
• Subjects: Adjuvant chemotherapy; Antineoplastic agents; Carcinoma; Carcinoma of external auditory canal; Care and treatment; Dosage and administration; Health aspects; neoadjuvant chemotherapy; Original; ORIGINAL ARTICLE; unresectable; India; neoadjuvant chemotherapy; Carcinoma of external auditory canal; unresectable
• DOI: 10.4103/0971-5851.166734
• ISSN: 0971-5851

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.