• Familial multicentric non-chromaffin paragangliomas: a case report on a patient with glomus jugulare and bilateral carotid body tumours.

      Pereira, D T; Hunter, Robin D; Christie Hospital and Holt Radium Institute, Withington, Manchester, M20 9BX, England (1980-09)
    • Fractionated high dose rate brachytherapy moulds--a precise treatment for carcinoma of the pinna.

      Allan, Ernest; Stanton, Anthony; Pye, David A; Collins, Conor D; Perry, Lesley A; Filby, Maeve; Wilkinson, John M; Department of Clinical Oncology, Christie Hospital, Withington, Manchester, UK. (1998-09)
      BACKGROUND AND PURPOSE: The aim of this paper is to describe a fractionated high dose rate brachytherapy procedure for the treatment of small superficial cancers of the pinna and to report the outcome in a small series of patients. MATERIALS AND METHODS: Thirteen patients with superficial cancers of the pinna, not invading cartilage, have been treated and in the majority of cases the tumour thickness was determined by a transdermal ultrasound measurement. For the single-plane moulds the prescribed surface dose was 45 Gy in eight fractions over 5 days and the moulds were constructed such that the full thickness of the disease, as determined by the ultrasound measurement, would lie within the 80% isodose surface. One case was treated with a sandwich mould and in this case the dose was reduced to 42.5 Gy. The treatment machine was a high dose rate microselectron, which contains a single stepping iridium source. RESULTS: The radiation reactions were of moderate severity, but were limited to the high dose volume. In all cases there was complete tumour resolution and rapid healing occurred leaving a barely perceptible scar. There were no recurrences over a minimum follow-up time of 18 months and there were no late radiation complications in this period. CONCLUSIONS: The treatment of superficial carcinoma of the pinna by means of HDR moulds is a safe and reliable technique. In this small series of patients there was total tumour control with excellent cosmesis.
    • Megavoltage electron beam therapy in the treatment of basal and squamous cell carcinomata of the pinna.

      Hunter, Robin D; Pereira, D T M; Pointon, R C S; Christie Hospital and Holt Radium Institute, Manchester M20 9BX, UK (1982-05-03)
      Kilovoltage X-ray therapy has considerable limitations when trying to obtain good functional results in patients with skin carcinomas arising on the pinna. Megavoltage electron beams with their better quality of radiation and homogeneous dose distribution have been recognised to have theoretical advantages. Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron mean therapy are discussed.
    • Primary radical radiotherapy for squamous cell carcinoma of the middle ear and external auditory cana--an historical series.

      Pemberton, Laura S; Swindell, Ric; Sykes, Andrew J; Weston Park Hospital, Sheffield, UK. pembertonlaura@hotmail.com (2006-06)
      AIMS: To evaluate patients treated with radical radiotherapy alone for squamous cell carcinoma of the middle ear (MEC) and external auditory canal (EAC) in terms of freedom from local recurrence, cancer-specific survival and morbidity. MATERIALS AND METHODS: Between 1965 and 1988, 123 patients were treated, 70 with MEC and 53 with EAC. The median age was 64 years (range 21-86) and 78% presented as late stage. The median dose was 55 Gy (range 39-55) in 16 once daily fractions (range 13-21). RESULTS: At 5 and 10 years, respectively, freedom from local recurrence was 56 and 56%, disease-free survival was 45 and 43%, cancer-specific survival was 53 and 51%, and overall survival was 40 and 21%. Cancer-specific survival was significantly worse with late stage as opposed to early stage (P = 0.0026), as was local recurrence (P = 0.0088). No differences in survival and local control were seen according to site. Radionecrosis developed in 6% of patients. CONCLUSIONS: Combined treatment using radiotherapy and radical surgery is often favoured. This large series shows that radical radiotherapy achieves comparable results in terms of local control and cancer-specific survival. Our radiotherapy regimen is now 55 Gy in 20 daily fractions to reduce late morbidity. Radiotherapy alone remains a viable option, especially as morbidity can be minimised and target volume delineation optimised using computer planning in the future.
    • Radical radiotherapy alone for glomus jugulare and tympanicum tumours.

      Pemberton, Laura S; Swindell, Ric; Sykes, Andrew J; Department of Clinical Oncology, Christie Hospital, Manchester, UK. (2005-12)
      The management of glomus jugulare and tympanicum tumours is controversial due the long natural history and morbidity associated with intervention. We report the experience of radical radiotherapy (RT) alone for these tumours. Between 1965 and 1987, 49 patients received RT. Median age at presentation was 55 years (range, 23-82). Common presentations were deafness in 27 patients, tinnitus in 25 and cranial nerve palsies in 18. RT was given as a 2D simulator-planned wedge pair in the majority with a median dose of 45 Gy (range, 37.5-50.0) in 15 or 16 fractions over 21 days (range, 20-26). Median follow-up was 7.4 years (range, 2.0-23.4). At 6 months post-RT, complete clinical response was seen in 38 patients, partial response in 4, no response in 1 and no data were available for 6. At both 5 and 10 years, 92% of patients were recurrence-free and cancer-specific survival was 96%. There were no reports of radionecrosis. Although tumour eradication is not the aim, RT can achieve good local control, survival and symptom relief without the significant morbidity that can be associated with radical surgery. Therefore, RT alone has a significant role in the management of these tumours.