Li Zheng-jiang, Li Hui-zheng, Liu Wen-sheng, Xu Zhen-gang, Tang Ping-zhang
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China.
Zhonghua Yi Xue Za Zhi. 2008 Dec 16;88(46):3275-8.
To seek a best therapeutic protocol for small cell neuroendocrine carcinoma of head and neck.
The clinical data of 34 patients with small cell neuroendocrine carcinoma of head and neck, 21 males and 13 females, aged 53 (17 - 71), were retrospectively analyzed. The therapeutic protocols that had been used for the patients included surgery alone (in 5 patients), radiotherapy alone (in 7 patients), combined therapy with surgery and radiotherapy (in 7 patients), combined therapy with surgery and chemotherapy (for 3 patients), combined therapy with radiotherapy and chemotherapy (for 10 patients), and combined therapy with surgery, radiotherapy and chemotherapy (for 2 patients). The follow-up ended on August 1 2007.
The prognosis of the patient with small cell neuroendocrine carcinoma of skin was the best. Local recurrence occurred in 7 patients, of which 2 underwent surgery alone, 2 combined therapy with surgery and radiotherapy, 1 combined therapy with surgery and chemotherapy, and 2 combined therapy with radiotherapy and chemotherapy. Recurrence in neck occurred in 1 patient that had undergone combined therapy with surgery and radiotherapy. Neck lymph node metastasis was found in 4 patients of whom 2 had undergone surgery alone, 1 had undergone combined therapy with surgery and chemotherapy, and 1 combined therapy with radiotherapy and chemotherapy. Distant metastasis was found in 11 patients of whom 2 had undergone surgery alone, 2 radiotherapy alone, 3 combined therapy with surgery and radiotherapy, and 3 combined therapy with radiotherapy and chemotherapy. The median survival time was 24 months, and the overall 3-year and 5-year cumulative survival rates were 65.37% and 35.95% respectively.
The prognosis of the patient with small cell neuroendocrine carcinoma of head and neck was poor. Small cell neuroendocrine carcinoma cases with the lesions at different sites differ in prognosis and needed different therapeutic fashions. Combined therapy with radiotherapy and chemotherapy is recommended for small cell neuroendocrine carcinoma of head and neck, and surgery serves as a salvage therapeutic measure.
探寻头颈部小细胞神经内分泌癌的最佳治疗方案。
回顾性分析34例头颈部小细胞神经内分泌癌患者的临床资料，其中男性21例，女性13例，年龄53岁（17 - 71岁）。用于这些患者的治疗方案包括单纯手术（5例）、单纯放疗（7例）、手术联合放疗（7例）、手术联合化疗（3例）、放疗联合化疗（10例）以及手术、放疗和化疗联合（2例）。随访截至2007年8月1日。
皮肤小细胞神经内分泌癌患者的预后最佳。7例出现局部复发，其中2例接受单纯手术，2例接受手术联合放疗，1例接受手术联合化疗，2例接受放疗联合化疗。1例接受手术联合放疗的患者出现颈部复发。4例发现颈部淋巴结转移，其中2例接受单纯手术，1例接受手术联合化疗，1例接受放疗联合化疗。11例出现远处转移，其中2例接受单纯手术，2例接受单纯放疗，3例接受手术联合放疗，3例接受放疗联合化疗。中位生存时间为24个月，3年和5年总累积生存率分别为65.37%和35.95%。
头颈部小细胞神经内分泌癌患者预后较差。不同部位病变的小细胞神经内分泌癌病例预后不同，需要不同的治疗方式。对于头颈部小细胞神经内分泌癌，推荐放疗联合化疗，手术作为挽救性治疗措施。
