Department of Radiation Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
Department of Radiology, Kurume University School of Medicine, 67 Asahimachi, Kurume city, Fukuoka 830-0011, Japan.
J Radiat Res. 2022 Dec 6;63(6):879-883. doi: 10.1093/jrr/rrac054.
Sinonasal undifferentiated carcinoma (SNUC) is a highly aggressive and uncommon neoplasm that arises from the mucosa of the nasal cavity or paranasal sinuses. The multidisciplinary approach that includes surgery, radiation therapy (RT), and chemotherapy has been proven to improve survival rates. However, there is no established evidence for the efficacy of further (boost) irradiation following definitive RT in SNUC patients with residual primary tumor. We describe a successful case of a patient with SNUC who had an uncontrolled primary tumor following induction chemotherapy and radical concurrent chemoradiotherapy (CCRT) and underwent a high-dose-rate interstitial brachytherapy (HDR-ISBT) boost. A 75-year-old Japanese woman with unresectable locally advanced SNUC (LA-SNUC) received induction chemotherapy followed by radical CCRT. However, because the residual primary tumor was evident after planned external beam RT, she underwent an HDR-ISBT boost, and the tumor decreased significantly. A complete response (the Response Evaluation Criteria in Solid Tumors, ver. 1.1) was achieved 2 months after brachytherapy, and the patient has been disease-free for 2 years following treatment initiation. In conclusion, an HDR-ISBT boost can be a safe and effective treatment option in patients with residual and inoperable LA-SNUC in the maxillary sinus after initial RT.
鼻腔鼻窦未分化癌（SNUC）是一种高度侵袭性和罕见的肿瘤，起源于鼻腔或副鼻窦的黏膜。包括手术、放射治疗（RT）和化疗在内的多学科治疗方法已被证明可提高生存率。然而，对于接受根治性 RT 后残余原发性肿瘤的 SNUC 患者，进一步（推量）照射的疗效尚无明确证据。我们描述了一例成功的 SNUC 患者病例，该患者在诱导化疗和根治性同期放化疗（CCRT）后原发性肿瘤失控，并接受了高剂量率间质近距离放疗（HDR-ISBT）推量。一位 75 岁的日本女性患有不可切除的局部晚期 SNUC（LA-SNUC），接受了诱导化疗，随后进行了根治性 CCRT。然而，由于计划外的外部束 RT 后仍有明显的残余原发性肿瘤，她接受了 HDR-ISBT 推量，肿瘤显著缩小。在近距离放疗后 2 个月达到完全缓解（实体瘤反应评估标准，ver.1.1），治疗开始后 2 年患者无疾病。总之，对于接受初始 RT 后上颌窦内残余和不可手术的 LA-SNUC 患者，HDR-ISBT 推量是一种安全有效的治疗选择。
