title: Hypofractionated Stereotactic Radiotherapy for Auditory Canal or Middle Ear Cancer.
abstract: BACKGROUND
  Stereotactic radiotherapy (SRT) may represent a new treatment option for individuals with auditory canal or middle ear cancer.
  
  
  METHODS
  Study participants with pathologically proven ear cancer were treated with SRT (35 Gy for 3 fractions or 40 Gy for 5 fractions) as first-line therapy. When local tumor recurrence developed following SRT, subtotal temporal bone resection and postoperative chemoradiotherapy were performed as salvage treatment. Boluses were used for the initial 14 study patients.
  
  
  RESULTS
  Twenty-nine study participants were enrolled and staged with T1 (n = 3), T2 (n = 7), T3 (n = 14), or T4 disease (n = 5). Three-year overall survival rates were 69% for T1/2 disease, 79% for T3 disease, and 0% for T4 disease. Three-year local control rates were 70% for T1/2 disease, 50% for T3 disease, and 20% for T4 disease. Grade 2 or higher dermatitis or soft-tissue necrosis occurred more frequently in study patients treated with boluses (8/14 vs 2/15; P = .02). Salvage treatment was safely performed for 12 recurrent cases.
  
  
  CONCLUSIONS
  These results suggest that SRT outcomes are promising for patients with ear cancer (? T3 disease). The rate of toxicity was acceptable in the study patients treated without boluses. Outcomes of salvage surgery and postoperative radiotherapy following SRT were also encouraging.
authors.affiliation: Department of Radiology, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan. taro8864@yahoo.co.jp.
authors.forename: Taro
authors.initials: T
authors.lastname: Murai
authors.forename: Shin-Etsu
authors.initials: SE
authors.lastname: Kamata
authors.forename: Kengo
authors.initials: K
authors.lastname: Sato
authors.forename: Kouki
authors.initials: K
authors.lastname: Miura
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Inoue
authors.forename: Naoki
authors.initials: N
authors.lastname: Yokota
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohta
authors.forename: Michio
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Iwata
authors.forename: Yuta
authors.initials: Y
authors.lastname: Shibamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D004428:Ear Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D004432:Ear, Middle / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011878:Radiotherapy / Q000379:methods*; D015996:Survival Rate