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Radiotherapy for Temporal Bone Cancers

  • Sweet Ping Ng
  • G. Brandon Gunn
Chapter

Abstract

Temporal bone cancer is an extremely rare head and neck cancer, accounting for only 0.2% of all head and neck squamous cell carcinomas. Although there has been no consensus of optimal treatment strategies for temporal bone cancers, it is generally accepted that postoperative radiation therapy improves locoregional control in high-risk cases. There have been reports on the role of definitive radiotherapy with/without concurrent chemotherapy in patients with locally advanced disease with comparable outcomes to surgery. Although the number of patients in these studies is small and the significance of results remained debatable, it indicated that radiation therapy remained a viable option for patients with non-operable disease. Delivering radiation therapy in this delicate area of the head and neck remains a challenge due to the proximity of critical neural and bony structures to the tumor. Radiation therapy can lead to significant late effects. Therefore, it is imperative to monitor patients for years after radiotherapy for tumor recurrence and possible late effects. In this chapter, we will present several cases to highlight treatment planning challenges and different radiation modalities that can be utilized in patients with tumors involving the temporal bone.

Keywords

Radiotherapy Photon Proton Definitive Toxicity 

Abbreviations

CRT

Chemoradiotherapy

CT

Computed tomography

FDG

Fluorodeoxyglucose

Gy

Gray

IMPT

Intensity-modulated proton therapy

IMRT

Intensity-modulated radiation (photon) therapy

IORT

Intraoperative radiation therapy

MRI

Magnetic resonance imaging

PET

Positron emission tomography

PORT

Postoperative radiotherapy

SCC

Squamous cell carcinoma

VMAT

Volumetric modulated arc therapy

References

  1. 1.
    Zanoletti E, Lovato A, Stritoni P, Martini A, Mazzoni A, Marioni G. A critical look at persistent problems in the diagnosis, staging and treatment of temporal bone carcinoma. Cancer Treat Rev. 2015;41(10):821–6.  https://doi.org/10.1016/j.ctrv.2015.10.007.CrossRefPubMedGoogle Scholar
  2. 2.
    Masterson L, Rouhani M, Donnelly NP, Tysome JR, Patel P, Jefferies SJ, et al. Squamous cell carcinoma of the temporal bone: clinical outcomes from radical surgery and postoperative radiotherapy. Otol Neurotol. 2014;35(3):501–8.  https://doi.org/10.1097/MAO.0000000000000265.CrossRefPubMedGoogle Scholar
  3. 3.
    Moffat DA, Wagstaff SA, Hardy DG. The outcome of radical surgery and postoperative radiotherapy for squamous carcinoma of the temporal bone. Laryngoscope. 2005;115(2):341–7.  https://doi.org/10.1097/01.mlg.0000154744.71184.c7.CrossRefPubMedGoogle Scholar
  4. 4.
    Zhang T, Li W, Dai C, Chi F, Wang S, Wang Z. Evidence-based surgical management of T1 or T2 temporal bone malignancies. Laryngoscope. 2013;123(1):244–8.  https://doi.org/10.1002/lary.23637.CrossRefPubMedGoogle Scholar
  5. 5.
    Cristalli G, Mercante G, Marucci L, Soriani A, Telera S, Spriano G. Intraoperative radiation therapy as adjuvant treatment in locally advanced stage tumours involving the middle ear: a hypothesis-generating retrospective study. Acta Otorhinolaryngol Ital. 2016;36(2):85–90.  https://doi.org/10.14639/0392-100X-486.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Pfreundner L, Schwager K, Willner J, Baier K, Bratengeier K, Brunner FX, et al. Carcinoma of the external auditory canal and middle ear. Int J Radiat Oncol Biol Phys. 1999;44(4):777–88.CrossRefGoogle Scholar
  7. 7.
    Bibas AG, Ward V, Gleeson MJ. Squamous cell carcinoma of the temporal bone. J Laryngol Otol. 2008;122(11):1156–61.  https://doi.org/10.1017/S0022215107001338.CrossRefPubMedGoogle Scholar
  8. 8.
    Prasad SC, D’Orazio F, Medina M, Bacciu A, Sanna M. State of the art in temporal bone malignancies. Curr Opin Otolaryngol Head Neck Surg. 2014;22(2):154–65.  https://doi.org/10.1097/MOO.0000000000000035.CrossRefPubMedGoogle Scholar
  9. 9.
    Ogawa K, Nakamura K, Hatano K, Uno T, Fuwa N, Itami J, et al. Treatment and prognosis of squamous cell carcinoma of the external auditory canal and middle ear: a multi-institutional retrospective review of 87 patients. Int J Radiat Oncol Biol Phys. 2007;68(5):1326–34.  https://doi.org/10.1016/j.ijrobp.2007.01.052.CrossRefPubMedGoogle Scholar
  10. 10.
    Morita S, Homma A, Nakamaru Y, Sakashita T, Hatakeyama H, Kano S, et al. The outcomes of surgery and chemoradiotherapy for temporal bone cancer. Otol Neurotol. 2016;37(8):1174–82.  https://doi.org/10.1097/MAO.0000000000001152.CrossRefPubMedGoogle Scholar
  11. 11.
    Shinomiya H, Hasegawa S, Yamashita D, Ejima Y, Kenji Y, Otsuki N, et al. Concomitant chemoradiotherapy for advanced squamous cell carcinoma of the temporal bone. Head Neck. 2016;38(Suppl 1):E949–53.  https://doi.org/10.1002/hed.24133.CrossRefPubMedGoogle Scholar
  12. 12.
    Takenaka Y, Cho H, Nakahara S, Yamamoto Y, Yasui T, Inohara H. Chemoradiation therapy for squamous cell carcinoma of the external auditory canal: a meta-analysis. Head Neck. 2015;37(7):1073–80.  https://doi.org/10.1002/hed.23698.CrossRefPubMedGoogle Scholar
  13. 13.
    Lambert EM, Gunn GB, Gidley PW. Effects of radiation on the temporal bone in patients with head and neck cancer. Head Neck. 2016;38(9):1428–35.  https://doi.org/10.1002/hed.24267.CrossRefPubMedGoogle Scholar
  14. 14.
    Valk PE, Dillon WP. Radiation injury of the brain. AJNR Am J Neuroradiol. 1991;12(1):45–62.PubMedGoogle Scholar
  15. 15.
    Chong VF, Fan YF, Mukherji SK. Radiation-induced temporal lobe changes: CT and MR imaging characteristics. AJR Am J Roentgenol. 2000;175(2):431–6.  https://doi.org/10.2214/ajr.175.2.1750431.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Radiation OncologyThe University of Texas M.D. Anderson Cancer CenterHoustonUSA

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