Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale U,Parini, AUSL Valle d'Aosta, Viale Ginevra n° 3, 11100 Aosta, Italy.
Radiat Oncol. 2012 Feb 15;7:21. doi: 10.1186/1748-717X-7-21.
Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure.
We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects.
One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects.
The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques.
头颈部非鼻旁窦神经内分泌癌（NSNEC）被认为是一种罕见的临床病理实体。对于未分化形式，联合治疗是一种既定的治疗选择，因为远处转移是常见的失败模式。
我们报告了一例 NSNEC 患者的治疗情况，该患者接受了顺铂和依托泊苷的序贯化疗 6 个周期，然后进行头颈部局部放疗和预防性颅照射，以防止颅内扩散，采用螺旋断层放疗和“海马回避”技术进行，以减少神经认知的迟发性副作用。
在整个联合治疗方法结束一年后，患者达到完全缓解，无治疗相关的亚急性和迟发性副作用。
本报告强调了对头颈部 NSNEC 进行多学科管理的重要性，因为现代放疗技术有可能实现高治愈率，同时副作用较轻。
