Department for Hematology, Oncology and Palliative Care, Academic Teaching Hospital Bielefeld, Bielefeld, Germany.
Eur J Cancer Care (Engl). 2013 Sep;22(5):648-52. doi: 10.1111/ecc.12070. Epub 2013 May 23.
Poorly differentiated head and neck neuroendocrine neoplasms are very rare. Surgical resection alone is insufficient to control the disease because of the high incidence of metastases. However, due to the lack of randomised clinical trials, treatment recommendations for this cancer vary considerably and are based on a limited number of small retrospective studies. We performed a retrospective analysis of all patients treated at our institution between 2003 and 2011. We assessed the stage of disease, type of therapy, toxicity, treatment response, time to progression and overall survival for all cases. Ten patients received combined modality treatment with chemotherapy in addition to surgery or radiation or both. According to Response Evaluation Criteria In Solid Tumours (RECIST) criteria, six of nine evaluable patients achieved complete remission and three patients had a partial remission. The mean duration of response was 358 days, with a range from 141 to 1080 days. The overall 1-year survival rate was 88%; however, only approximately 50% of patients were alive after 2 years. Multimodality treatment concepts induce high initial remission rates in poorly differentiated neuroendocrine head and neck carcinomas. However, the time to relapse is usually short, and therefore long-term prognosis of this rare head and neck tumour remains poor.
分化差的头颈部神经内分泌肿瘤非常罕见。由于转移率高，单纯手术切除不足以控制疾病。然而，由于缺乏随机临床试验，这种癌症的治疗建议差异很大，并且基于少数小型回顾性研究。我们对 2003 年至 2011 年间在我们机构治疗的所有患者进行了回顾性分析。我们评估了所有病例的疾病分期、治疗类型、毒性、治疗反应、进展时间和总生存期。十名患者接受了联合治疗，除了手术或放疗外，还接受了化疗。根据实体瘤反应评估标准 (RECIST)，九名可评估患者中的六名达到完全缓解，三名患者部分缓解。平均缓解持续时间为 358 天，范围为 141 至 1080 天。总的 1 年生存率为 88%；然而，只有大约 50%的患者在 2 年后仍然存活。多模式治疗方案在分化差的头颈部神经内分泌癌中诱导高初始缓解率。然而，复发的时间通常很短，因此这种罕见的头颈部肿瘤的长期预后仍然很差。
