Wang Cheng-Ping, Hsieh Chia-Ying, Chang Yih-Leong, Lou Pei-Jen, Yang Tsung-Lin, Ting Lai-Lei, Ko Jenq-Yuh
Institute of Biomedical Engineering, College of Medicine, National Taiwan University, Taipei, Taiwan.
Laryngoscope. 2008 May;118(5):804-9. doi: 10.1097/MLG.0b013e3181671491.
OBJECTIVES/HYPOTHESIS: Neuroendocrine carcinoma (NEC) of the sinonasal tract is rare. In this present study, we report our treatment experience with sinonasal NEC.
Retrospective case series.
A retrospective review of the clinical outcomes and pathology of 18 patients with NEC arising from the sinonasal region.
Ten tumors were primary NEC without previous radiation, and eight tumors were postirradiated NEC occurring within the radiation field for previous nasopharyngeal carcinoma in six patients and tonsillar lymphoma in one and neck metastasis of unknown primary origin in one, with an interval between previous radiotherapy and diagnosis of NEC from 82 to 385 months, with a mean of 197 months. Fifteen tumors were small cell carcinoma, two were atypical carcinoid, and one was typical carcinoid tumor. Fifteen patients underwent surgery with/without postoperative adjuvant chemoradiotherapy. Three patients received induction chemotherapy or primary radiotherapy with further definitive treatment. The 5-year disease-free and overall survival rates of all 18 patients were 56.1% and 62.2%, respectively. In comparing primary NEC with postirradiated NEC, they were similar in age, sex distribution, stage, pathology, and treatment, and the 5-year overall survival rates were 70% and 62.5%, respectively.
In this series, postirradiated NEC is common, which may be the result of there being a large number of long-term nasopharyngeal carcinoma survivors. The prognoses of postirradiated NEC and primary NEC appear to be similar despite the relatively short follow-up period in the postirradiated NEC group.
目的/假设：鼻窦神经内分泌癌（NEC）较为罕见。在本研究中，我们报告了鼻窦NEC的治疗经验。
回顾性病例系列研究。
回顾性分析18例鼻窦区域发生的NEC患者的临床结局和病理情况。
10例肿瘤为原发性NEC，既往无放疗史；8例肿瘤为放疗后NEC，其中6例发生于既往鼻咽癌放疗野内，1例发生于扁桃体淋巴瘤放疗野内，1例发生于颈部不明原发灶转移灶放疗野内，既往放疗与NEC诊断的间隔时间为82至385个月，平均197个月。15例肿瘤为小细胞癌，2例为非典型类癌，1例为典型类癌肿瘤。15例患者接受了手术，术后接受或未接受辅助放化疗。3例患者接受了诱导化疗或初始放疗，随后进行了确定性治疗。18例患者的5年无病生存率和总生存率分别为56.1%和62.2%。比较原发性NEC和放疗后NEC，两者在年龄、性别分布、分期、病理和治疗方面相似，5年总生存率分别为70%和62.5%。
在本系列研究中，放疗后NEC较为常见，这可能是由于有大量长期鼻咽癌幸存者。尽管放疗后NEC组的随访期相对较短，但放疗后NEC和原发性NEC的预后似乎相似。
