Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, 36-1 Nishicho, Yonago, Tottori 683-8504, Japan.
Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, 36-1 Nishicho, Yonago, Tottori 683-8504, Japan.
Auris Nasus Larynx. 2021 Dec;48(6):1189-1192. doi: 10.1016/j.anl.2020.07.002. Epub 2020 Jul 16.
Basaloid squamous cell carcinoma (BSCC), a histologically distinctive variant of squamous cell carcinoma comprising basal cell carcinoma and squamous cell carcinoma, is aggressive and shows a poor prognosis because of frequent lymph node invasion and distant metastases. To date few articles regarding chemotherapy for metastatic disease have been reported, thus feasible chemotherapy is not well established. Cetuximab is a monoclonal antibody for epithelial growth factor receptor (EGFR), which has great efficacy for head and neck squamous cell carcinoma due to EGFR signaling pathway blockage. Because BSCC also highly expresses EGFR, cetuximab may be effective for BSCC. We report here a first case of recurrent BSCC in the ethmoid sinus with intracranial extension treated with cetuximab-based chemotherapy, which revealed great response in a 40-year-old man. Positron emission tomography (PET) revealed no lymph node or distant metastasis. The patient underwent chemoradiotherapy 66 Gy in 33 fractions with triweekly 100 mg/m cisplatin. However, 12 weeks after treatment completion PET revealed a residual tumor at the primary cancer site. Combination therapy with weekly paclitaxel and cetuximab was started, and complete response was observed 2 months from treatment initiation. The patient has maintained complete response for 32 months, and no tumor regrowth has been observed.
基底样鳞状细胞癌（BSCC）是一种具有独特组织学特征的鳞状细胞癌，由基底细胞癌和鳞状细胞癌组成，具有侵袭性，预后不良，因为经常发生淋巴结侵犯和远处转移。迄今为止，很少有关于转移性疾病化疗的报道，因此可行的化疗尚未得到很好的确立。西妥昔单抗是一种针对表皮生长因子受体（EGFR）的单克隆抗体，由于 EGFR 信号通路阻断，对头颈鳞状细胞癌具有很好的疗效。由于 BSCC 也高度表达 EGFR，西妥昔单抗可能对 BSCC 有效。我们在此报告一例复发性筛窦 BSCC 伴颅内侵犯患者，该患者接受西妥昔单抗为基础的化疗治疗，显示出非常好的反应。正电子发射断层扫描（PET）未发现淋巴结或远处转移。患者接受了 66Gy 的顺铂三联周 100mg/m 2 的同期放化疗。然而，治疗完成后 12 周，PET 显示原发性肿瘤部位仍有残留肿瘤。开始联合每周紫杉醇和西妥昔单抗治疗，从治疗开始 2 个月后观察到完全缓解。患者已维持完全缓解 32 个月，未观察到肿瘤复发。
