Division of Thoracic Oncology, Shizuoka Cancer Center, 1007, Nagaizumi, Shizuoka 411-8777, Japan.
Lung Cancer. 2010 Jun;68(3):438-45. doi: 10.1016/j.lungcan.2009.07.003. Epub 2009 Aug 21.
Pulmonary large cell neuroendocrine carcinoma (LCNEC) shares several features with small cell lung carcinoma (SCLC). Most histologic diagnoses of LCNEC are currently obtained by surgical specimens. While the diagnosis of LCNEC by biopsy specimens is challenging, a definitive diagnosis of this highly malignant tumor is critical in unresectable cases to determine the optimal therapeutic strategy. The objective of this study was to assess the efficacy of chemotherapy for unresectable high-grade non-small cell neuroendocrine carcinoma (HNSCNEC) called by us, which likely includes most LCNECs except for combined types, and to compare the efficacy of chemotherapy for HNSCNEC, with that for extended disease SCLC (ED-SCLC).
Between September 2002 and October 2007, we reviewed 14 patients with HNSCNEC, which was defined using biopsy specimens according to histological and immunohistological criteria proposed by us. We simultaneously evaluated the clinical response to the chemotherapy and survival time of the 14 HNSCNEC and 77 ED-SCLC patients.
The chemotherapy regimens in the 14 patients with unresectable HNSCNEC were platinum-based combination regimens or irinotecan or vinorelbine or docetaxel alone. The chemotherapy regimens in the 77 patients with ED-SCLC were platinum-based combination regimens. We assessed an objective response rate, a one-year survival rate, and median survival time as 50% (7/14), 34% and 10 months, respectively, in the 14 HNSCNEC patients, and as 53% (41/77), 48% and 12.3 months, respectively, in the 77 ED-SCLC patients.
The clinical efficacy of chemotherapy for unresectable HNSCNECs, including most LCNECs, is comparable to that for ED-SCLC.
肺大细胞神经内分泌癌（LCNEC）与小细胞肺癌（SCLC）有一些共同特征。目前，大多数 LCNEC 的组织学诊断是通过手术标本获得的。虽然活检标本诊断 LCNEC 具有挑战性，但在不可切除的情况下，对这种高度恶性肿瘤的明确诊断对于确定最佳治疗策略至关重要。本研究的目的是评估我们所谓的不可切除高级别非小细胞神经内分泌癌（HNSCNEC）的化疗疗效，这可能包括大多数 LCNEC，除了混合类型，以及比较 HNSCNEC 与广泛期 SCLC（ED-SCLC）的化疗疗效。
在 2002 年 9 月至 2007 年 10 月期间，我们回顾了 14 例 HNSCNEC 患者的资料，这些患者是根据我们提出的组织学和免疫组织化学标准通过活检标本定义的。我们同时评估了 14 例 HNSCNEC 患者和 77 例 ED-SCLC 患者的化疗反应和生存时间。
14 例不可切除 HNSCNEC 患者的化疗方案为铂类联合化疗方案或伊立替康、长春瑞滨或多西他赛单药治疗。77 例 ED-SCLC 患者的化疗方案为铂类联合化疗方案。我们评估了 14 例 HNSCNEC 患者的客观缓解率、一年生存率和中位生存时间分别为 50%（7/14）、34%和 10 个月，77 例 ED-SCLC 患者分别为 53%（41/77）、48%和 12.3 个月。
包括大多数 LCNEC 在内的不可切除 HNSCNEC 化疗疗效与 ED-SCLC 相当。
