Iqbal Muhammad Shahid, Paleri Vinidh, Brown Jolene, Greystoke Alastair, Dobrowsky Werner, Kelly Charles, Kovarik Josef
Northern Centre for Cancer Care, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
Department of Head and neck surgery, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
Ecancermedicalscience. 2015 Nov 18;9:594. doi: 10.3332/ecancer.2015.594. eCollection 2015.
Spindle cell carcinoma of the head and neck is a rare entity and the evidence of optimal management is lacking. The objective of our study was to report the treatment and outcomes of 15 patients treated in a single institution over a seven year period.
A total of 15 patients (12 males and 3 females) with spindle cell carcinoma of the head and neck were treated between July 2007 to June 2014. In six patients the disease developed after previous radiotherapy. Of the 15 patients, five patients had their primary in the tongue, four in the paranasal sinuses, two in the hypopharynx, two in the vocal cords, and one each in the soft palate and the floor of mouth. Eleven patients were treated with radical intent (seven patients required surgery only and four were treated with combined modality). The remaining four patients were treated with palliative intent.
Among 11 patients treated with radical intent eight are alive or died of non-oncological causes. The disease recurred locally in three patients and they died of the disease (two patients with locally advanced disease in the tongue and one patient with T1N0 tumour in the hypopharynx). Median overall survival (OS) was 18 months.
Surgery or surgery combined with radiotherapy has a real impact on the natural cause of spindle cell carcinoma of the head and neck region. Even locally advanced tumours can be controlled with aggressive treatment. The worst outcome is seen with the tongue as the primary site because of a high local recurrence rate.
头颈部梭形细胞癌是一种罕见的疾病，目前缺乏最佳治疗方案的证据。我们研究的目的是报告在一家机构中7年内治疗的15例患者的治疗情况和结果。
2007年7月至2014年6月期间，共治疗了15例头颈部梭形细胞癌患者（12例男性，3例女性）。6例患者在先前接受放射治疗后发病。在这15例患者中，5例原发于舌部，4例原发于鼻窦，2例原发于下咽，2例原发于声带，1例原发于软腭，1例原发于口底。11例患者接受了根治性治疗（7例仅需手术，4例接受了综合治疗）。其余4例患者接受了姑息性治疗。
在11例接受根治性治疗的患者中，8例存活或死于非肿瘤原因。3例患者疾病局部复发并死于该疾病（2例舌部局部晚期疾病患者和1例下咽T1N0肿瘤患者）。中位总生存期（OS）为18个月。
手术或手术联合放疗对头颈部梭形细胞癌的自然病程有实际影响。即使是局部晚期肿瘤，积极治疗也可得到控制。由于局部复发率高，以舌部为原发部位的患者预后最差。
