LONG TIME STUDIES OF ADVANCED CANCER OF THE EAR TREATED WITH ELECTROSURGERY PLUS RADIATION

Abstract

This paper follows our first report on the same subject presented before the American Radium Society 24 years ago, in 1948. Records of 62 cases treated from 1940 to 1958 were collected and divided into 3 groups. The first group of 14 cases includes proven cures alive from 12 to 25 years (Table I). Two were excluded because 1 died of cancer of the skull near the original ear lesion at 15 years and 1 died of pulmonary metastases at 12 years with no evidence of cancer of the ear present. This leaves 12, or 85 per cent, of the original 14 cases well from 12 to 25 years. All of these, except 1, were treated by the removal of the original lesion with electrosurgery plus the implantation of low intensity radium needles beneath the remaining malignant tissue for 7 days. The 1 exceptional case had a large squamous cell carcinoma surrounding the original site of the ear plus extension into the mastoid and bone surrounding the internal ear. Treatment was started with 3,600 r (air) given through a large port to the entire lesion in a period of 13 days using orthovoltage. Six weeks later the tumor showed marked improvement, but the remaining portion was then destroyed by careful electrocoagulation of the mastoid and residual involved bone beneath the ear. This patient had no cancer of the ear at the end of 23 years. The second group includes 25 favorable cases treated successfully from 1947 to 1958 (Table II). Although not 1 of these patients is alive at 10 years, 14 died from 1 to 7 years of intercurrent diseases with no cancer of the ear present and 1 died at 6 years in an automobile accident with the ear perfectly well. An additional 7 were lost to follow-up with the ear well at the last visit. This leaves 3 patients known dead of cancer of the ear at 10, 5, and 3 years and 22 possibly well. The third group of 23 cases (Table III) treated from 1940 to 1958 were all considered incurable at admission and none of them survived. Sixteen had received very large doses of irradiation elsewhere before admission and the others were over or undertreated, or cures were unsuccessfully attempted with orthovoltage alone or radical surgery.