Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal

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 t...

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Main Authors: Amit Joshi, Nidhi Tandon, Vanita Noronha, Sachin Dhumal, Vijay Patil, Supreeta Arya, Shashikant Juvekar, Jaiprakash Agarwal, Anil DCruz, Prathmesh Pai, Kumar Prabhash
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2015-01-01
Series:Indian Journal of Medical and Paediatric Oncology
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Online Access:http://www.ijmpo.org/article.asp?issn=0971-5851;year=2015;volume=36;issue=3;spage=172;epage=175;aulast=Joshi
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author Amit Joshi
Nidhi Tandon
Vanita Noronha
Sachin Dhumal
Vijay Patil
Supreeta Arya
Shashikant Juvekar
Jaiprakash Agarwal
Anil DCruz
Prathmesh Pai
Kumar Prabhash
author_facet Amit Joshi
Nidhi Tandon
Vanita Noronha
Sachin Dhumal
Vijay Patil
Supreeta Arya
Shashikant Juvekar
Jaiprakash Agarwal
Anil DCruz
Prathmesh Pai
Kumar Prabhash
author_sort Amit Joshi
collection DOAJ
description 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.
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spelling doaj-art-5cbeee0b5e17445f8d6e31b8e011457a2025-08-20T03:09:52ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Medical and Paediatric Oncology0971-58512015-01-0136317217510.4103/0971-5851.166734Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canalAmit JoshiNidhi TandonVanita NoronhaSachin DhumalVijay PatilSupreeta AryaShashikant JuvekarJaiprakash AgarwalAnil DCruzPrathmesh PaiKumar PrabhashBackground: 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.http://www.ijmpo.org/article.asp?issn=0971-5851;year=2015;volume=36;issue=3;spage=172;epage=175;aulast=JoshiCarcinoma of external auditory canalneoadjuvant chemotherapyunresectable
spellingShingle Amit Joshi
Nidhi Tandon
Vanita Noronha
Sachin Dhumal
Vijay Patil
Supreeta Arya
Shashikant Juvekar
Jaiprakash Agarwal
Anil DCruz
Prathmesh Pai
Kumar Prabhash
Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
Indian Journal of Medical and Paediatric Oncology
Carcinoma of external auditory canal
neoadjuvant chemotherapy
unresectable
title Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
title_full Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
title_fullStr Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
title_full_unstemmed Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
title_short Neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
title_sort neoadjuvant chemotherapy in technically unresectable carcinoma of external auditory canal
topic Carcinoma of external auditory canal
neoadjuvant chemotherapy
unresectable
url http://www.ijmpo.org/article.asp?issn=0971-5851;year=2015;volume=36;issue=3;spage=172;epage=175;aulast=Joshi
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AT sachindhumal neoadjuvantchemotherapyintechnicallyunresectablecarcinomaofexternalauditorycanal
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