[Predictive significance of reflex otalgia in local radical radiotherapy of oropharyngeal carcinomas].
BACKGROUND
Patients with carcinomas of the upper aero-digestive tract often suffer from ear pain as a tumor associated syndrome. This prospective study examines the predictive and prognostic value of this symptom.


METHODS
Ninety-six consecutive patients who completed a locally radiotherapy of a carcinoma of the oropharynx were prospectively evaluated and followed. Forty-nine out of 96 patients stated the symptom, either spontaneously or after questioning. The 2 groups showed no difference regarding TNM-classification, histology and total dose. Overall survival, local control and disease specific survival were calculated according to Kaplan-Meier and compared by the log-rank test.


RESULTS
A clinically complete remission was obtained in significantly fewer patients with reflex-otalgia as compared to patients without reflex-otalgia, 61.2% versus 89.3%, p < 0.002. Local control of patients with reflex-otalgia was significantly less with 49%, mean follow-up 564 days, in comparison to local control in patients without reflex-otalgia, mean follow-up 613 days, p = 0.01. Disease specific survival was significantly worse for patients with reflex-otalgia, p < 0.012. The probability of local control of T1/T2 tumors with reflex-otalgia was similar to T3/T4 tumors without reflex-otalgia. Local control for all tumor categories combined is 74% for patients without reflex-otalgia versus 49% for patients with reflex-otalgia.


CONCLUSIONS
In our patients, reflex-otalgia is a new and statistically significant parameter for the probability of local control and disease specific survival.
Beer
K T
KT
Klinik für Radioonkologie, Inselspital, Universität Bern, Schweiz. karl.beer@insel.ch
von Briel
C
C
Lampret
T
T
Marré
S
S
Vetterli
D
D
Zbären
P
P
Greiner
R H
RH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D004433:Earache / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D010257:Paraneoplastic Syndromes / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011446:Prospective Studies; D011882:Radiotherapy, High-Energy; D012021:Reflex, Abnormal / Q000528:radiation effects*; D016019:Survival Analysis
Prädiktive Bedeutung der Reflexotalgie in der lokal radikalen Radiotherapie von Oropharynxkarzinomen.