Background: There is no consensus regarding the indication for postoperative radiotherapy (PORT) for T1- and T2-classified squamous cell carcinoma (SCC) of the external auditory canal (EAC) even with negative surgical margins. This study aimed to evaluate whether PORT provides additional benefits for these cases. Methods: We collected retrospective data from fourteen international hospitals, including resected pT1- and pT2-classified EAC SCC with negative surgical margins. Results: A total of 112 early-stage radically resected EAC SCC were included, with 48 patients receiving PORT. The 5-year DFS of T1- and T2-classified EAC SCC treated with PORT was not statistically significantly different (92.9% and 76.9%, respectively) compared to the group treated without PORT (100% and 90.9%, respectively;p-values of 0.999 and 0.526, respectively). EAC SCC treated with PORT more frequently exhibited perineural and angioinvasive growth. Eighteen patients experienced side effects related to radiotherapy, of which one patient developed osteoradionecrosis. Conclusions: Our study suggests that PORT for early-stage radically resected EAC SCC should only be considered in selected cases with perineural, infiltrative growth or angioinvasive growth, and with a close margin. This approach helps mitigate the negative impact on quality of life and the risk of side effects associated with radiotherapy.
背景：对于手术切缘阴性的T1和T2分期外耳道鳞状细胞癌，术后放疗的适应症目前尚无共识。本研究旨在评估术后放疗是否能为此类病例带来额外获益。方法：我们收集了来自14家国际医院的回顾性数据，纳入研究对象为手术切缘阴性的pT1和pT2分期外耳道鳞状细胞癌根治性切除病例。结果：共纳入112例早期外耳道鳞状细胞癌根治切除病例，其中48例接受了术后放疗。接受术后放疗的T1和T2分期患者5年无病生存率（分别为92.9%和76.9%）与未接受术后放疗组（分别为100%和90.9%）相比无统计学显著差异（p值分别为0.999和0.526）。接受术后放疗的外耳道鳞状细胞癌病例更常出现神经周围浸润和血管侵犯。18例患者出现放疗相关副作用，其中1例发生放射性骨坏死。结论：本研究提示，对于根治性切除的早期外耳道鳞状细胞癌，术后放疗应仅考虑用于存在神经周围浸润、侵袭性生长或血管侵犯且切缘接近的特定病例。这种策略有助于减轻对生活质量的负面影响，并降低放疗相关副作用的风险。
肿瘤(癌症)患者之家