Ock Chan-Young, Keam Bhumsuk, Kim Tae Min, Han Doo Hee, Won Tae-Bin, Lee Se-Hoon, Hah J Hun, Kwon Tack-Kyun, Kim Dong-Wan, Kim Dong-Young, Rhee Chae-Seo, Wu Hong-Gyun, Sung Myung-Whun, Heo Dae Seog
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
Korean J Intern Med. 2016 May;31(3):570-8. doi: 10.3904/kjim.2015.020. Epub 2016 Mar 15.
BACKGROUND/AIMS: The role of induction chemotherapy (IC) for eyeball preservation has not been established in head and neck squamous cell carcinoma (HNSCC) of the paranasal sinus and nasal cavity (PNSNC). Periorbital involvement frequently leads to eyeball exenteration with a margin of safety. We evaluated the treatment outcomes, including survival and eyeball preservation, of patients who received IC for HNSCC of the PNSNC.
We reviewed 21 patients diagnosed with HNSCC of the PNSNC who were treated with IC. We analyzed response, eyeball preservation rate, and overall survival.
Tumors were located in the paranasal sinus (n = 14) or nasal cavity (n = 7). Most patients had stage T4a (n = 10) or T4b (n = 7) disease. More than half of the patients received a chemotherapy regimen of docetaxel, fluorouracil, and cisplatin (n = 11). Thirteen patients (61.9%) achieved a partial response after IC and 15 patients (71.4%) achieved T down-staging. Among 17 patients with stage T4 disease, which confers a high risk of orbital exenteration, 14 (82.4%) achieved preservation of the involved eye. The 3-year overall survival (OS) rate of patients who achieved a partial response to IC was 84.6%. The 3-year OS rate of patients with stable disease or disease progression after IC was 25.0% (p = 0.038).
IC could be considered for down-staging patients with advanced T-stage disease. It could also be a reasonable option for eyeball preservation in locally advanced HNSCC of the PNSNC.
背景/目的：诱导化疗（IC）在鼻窦和鼻腔（PNSNC）的头颈部鳞状细胞癌（HNSCC）中对于眼球保留的作用尚未确立。眶周受累常导致眼球安全边缘性眶内容剜除术。我们评估了接受IC治疗的PNSNC-HNSCC患者的治疗结果，包括生存率和眼球保留情况。
我们回顾了21例经诊断为PNSNC-HNSCC并接受IC治疗的患者。我们分析了反应、眼球保留率和总生存率。
肿瘤位于鼻窦（n = 14）或鼻腔（n = 7）。大多数患者患有T4a期（n = 10）或T4b期（n = 7）疾病。超过一半的患者接受了多西他赛、氟尿嘧啶和顺铂的化疗方案（n = 11）。13例患者（61.9%）在IC后达到部分缓解，15例患者（71.4%）实现了T分期降期。在17例具有高眶内容剜除风险的T4期疾病患者中，14例（82.4%）实现了受累眼的保留。对IC有部分反应的患者的3年总生存率（OS）为84.6%。IC后疾病稳定或进展的患者的3年OS率为25.0%（p = 0.038）。
对于T分期晚期的患者，IC可考虑用于降期。它也可能是PNSNC局部晚期HNSCC中眼球保留的合理选择。
