Hatoum Georges F, Patton Brandon, Takita Cristiane, Abdel-Wahab May, LaFave Kelly, Weed Donald, Reis Isildinha M
Department of Radiation Oncology, University of Miami Leonard Miller School of Medicine, FL 33136, USA.
Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):477-81. doi: 10.1016/j.ijrobp.2008.08.014. Epub 2008 Nov 10.
To describe the University of Miami experience in the treatment of small cell carcinoma of the head and neck.
A total of 12 patients with nonmetastatic small cell carcinoma of the head and neck were treated between April 1987 and September 2007. Radiotherapy was the primary local treatment modality for 8 patients.
Of the 12 patients, 8 had died after a median follow-up of 13 months. The 4 patients who were alive were followed for a median of 14 months. The Kaplan-Meier estimate of the proportion of small cell head-and-neck cancer patients surviving to 1 and 2 years was 63% and 26%, respectively. The percentage of patients remaining disease free at 1 and 2 years was 71% and 44%, respectively. The patients with tonsil/parotid gland cancer had significantly greater disease-specific survival compared with the other patients. The median survival time was 30 months in the tonsil/parotid group compared with 15.2 months in the other group (patients with small cell carcinoma of the sinonasal cavity, nasopharynx, and larynx). A total of 4 patients developed recurrence, 3 of whom had a distant failure component. The treatment modality was not associated with a difference in disease-specific survival. The 1-year disease-specific survival rate was 73% in the radiotherapy or radiotherapy/chemotherapy group compared with 67% in the other group.
Radiotherapy with or without chemotherapy is a reasonable alternative to surgery for patients with small cell carcinoma of the head and neck. Patients with tonsillar or parotid small cell carcinomas did better than other sites. More aggressive treatment might be warranted for patients with sinonasal carcinoma. The outcome, however, continues to be suboptimal, and more effective therapy is needed because most patients had a component of local and distant failure.
描述迈阿密大学治疗头颈部小细胞癌的经验。
1987年4月至2007年9月期间，共治疗了12例非转移性头颈部小细胞癌患者。8例患者的主要局部治疗方式为放射治疗。
12例患者中，8例在中位随访13个月后死亡。4例存活患者的中位随访时间为14个月。头颈部小细胞癌患者1年和2年生存率的Kaplan-Meier估计值分别为63%和26%。1年和2年无病患者的百分比分别为71%和44%。扁桃体/腮腺癌患者的疾病特异性生存率明显高于其他患者。扁桃体/腮腺组的中位生存时间为30个月，而其他组（鼻窦腔、鼻咽和喉小细胞癌患者）为15.2个月。共有4例患者出现复发，其中3例有远处转移。治疗方式与疾病特异性生存率的差异无关。放射治疗或放射治疗/化疗组的1年疾病特异性生存率为73%，而另一组为67%。
对于头颈部小细胞癌患者，放疗联合或不联合化疗是一种合理的手术替代方案。扁桃体或腮腺小细胞癌患者的情况优于其他部位。鼻窦癌患者可能需要更积极的治疗。然而，由于大多数患者存在局部和远处转移，治疗效果仍然不理想，需要更有效的治疗方法。
