title: To analyze the impact of intracavitary brachytherapy as boost radiation after external beam radiotherapy in carcinoma of the external auditory canal and middle ear: a retrospective analysis.
abstract: OBJECTIVE
  The purpose of this study was to analyze the impact of intra-cavitary brachytherapy (ICBT) as boost radiation after external beam radiotherapy (EBRT) in carcinoma of the external auditory canal and middle ear (EACMA): A retrospective analysis.
  
  
  METHODS
  A retrospective study of 18 patients with carcinoma of the EACMA who were treated with a curative intent from the year 1998 to 2010 was carried out. The age of the patients ranged from 25 years to 67 years. There were 11 male patients (61.1%) and 7 female patients (38.9%). A total of 15 (88.2%) patients were treated with curative radiation alone after a biopsy and two patients received post-operative radiation therapy. The patients were initially treated with EBRT with cobalt 60 machine up to 60-64 Gy. In our department, all the patients who were technically suitable for ICBT received an ICBT boost.
  
  
  RESULTS
  The overall survival (OS) in these patients ranged from 7 months to 151 months (9 out of 17 patients, no evidence of disease 53%). The OS in patients treated with a combination of EBRT with ICBT was (8 out of 11) 72.7%, P value statistically significant (P value: 0.0024). The multivariate analysis shows statistically significant difference only for patients who got an ICBT boost (P Value: 0.020).
  
  
  CONCLUSIONS
  ICBT as a boost after EBRT has got a positive impact on the OS. In conclusion, our results demonstrate that radical radiation therapy (EBRT and ICBT) is the treatment of choice for stage T2, carcinoma of EACMA.
authors.affiliation: Department of Radiotherapy, Dr. D K Gosavi Memorial, Siddhivinayak Ganpati Cancer Hospital, Miraj, Maharashtra, India.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Badakh
authors.forename: Amit H
authors.initials: AH
authors.lastname: Grover
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002277:Carcinoma / Q000401:mortality / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004424:Ear Canal / Q000473:pathology; D004428:Ear Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D004432:Ear, Middle / Q000473:pathology; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016896:Treatment Outcome