Matsuyama Hiroshi, Ueki Yushi, Okamoto Isaku, Nagao Toshitaka, Honda Kohei, Yamazaki Keisuke, Okabe Ryuichi, Togashi Takafumi, Shodo Ryusuke, Ota Hisayuki, Takahashi Takeshi, Omata Jo, Yokoyama Yusuke, Saijo Kohei, Tanaka Ryoko, Tsukahara Kiyoaki, Kitahara Tadashi, Uemura Hirokazu, Yoshimoto Seiichi, Matsumoto Fumihiko, Okami Kenji, Sakai Akihiro, Takano Kenichi, Kondo Atsushi, Inohara Hidenori, Eguchi Hirotaka, Oridate Nobuhiko, Tanabe Teruhiko, Nakamizo Munenaga, Yokoshima Kazuhiko, Miura Koki, Kitani Yosuke, Horii Arata
Department of Otolaryngology, Niigata City General Hospital, Niigata, Japan.
Department of Otolaryngology, Head and Neck Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Front Surg. 2022 Nov 14;9:1049116. doi: 10.3389/fsurg.2022.1049116. eCollection 2022.
Basal information of head and neck small-cell carcinoma (HNSmCC) including epidemiology, primary site, treatment, and prognosis remains sparse due to its rarity. We report here a multicenter retrospective study on the diagnosis, treatment, and outcomes of patients with HNSmCC.
This study involved 47 patients with HNSmCC from 10 participating institutions. Eight patients were excluded for whom no pathological specimens were available ( = 2) and for discrepant central pathological judgements ( = 6). The remaining 39 patients were processed for data analysis.
As pretreatment examinations, computed tomography (CT) was performed for the brain ( = 8), neck ( = 39), and chest ( = 32), magnetic resonance imaging (MRI) for the brain ( = 4) and neck ( = 23), positron emission tomography-CT (PET-CT) in 23 patients, bone scintigraphy in 4, neck ultrasonography in 9, and tumor markers in 25. Primary sites were oral cavity ( = 1), nasal cavity/paranasal sinuses ( = 16), nasopharynx ( = 2), oropharynx ( = 4), hypopharynx ( = 2), larynx ( = 6), salivary gland ( = 3), thyroid ( = 2), and others ( = 3). Stages were II/III/IV-A/IV-B/IV-C/Not determined = 3/5/16/6/5/4; stage IV comprised 69%. No patient had brain metastases. First-line treatments were divided into 3 groups: the chemoradiotherapy (CRT) group ( = 27), non-CRT group ( = 8), and best supportive care group ( = 4). The CRT group included concurrent CRT (CCRT) ( = 17), chemotherapy (Chemo) followed by radiotherapy (RT) ( = 5), and surgery (Surg) followed by CCRT ( = 5). The non-CRT group included Surg followed by RT ( = 2), Surg followed by Chemo ( = 1), RT alone ( = 2), and Chemo alone ( = 3). The 1-year/2-year overall survival (OS) of all 39 patients was 65.3/53.3%. The 1-year OS of the CRT group (77.6%) was significantly better compared with the non-CRT group (31.3%). There were no significant differences in adverse events between the CCRT group ( = 22) and the Chemo without concurrent RT group ( = 9).
Neck and chest CT, neck MRI, and PET-CT would be necessary and sufficient examinations in the diagnostic set up for HNSmCC. CCRT may be recommended as the first-line treatment. The 1-year/2-year OS was 65.3%/53.3%. This study would provide basal data for a proposing the diagnostic and treatment algorithms for HNSmCC.
头颈部小细胞癌（HNSmCC）的基础信息，包括流行病学、原发部位、治疗及预后等，因其罕见而仍较为匮乏。我们在此报告一项关于HNSmCC患者诊断、治疗及结局的多中心回顾性研究。
本研究纳入了来自10个参与机构的47例HNSmCC患者。8例患者被排除，其中2例没有可用的病理标本，6例存在中央病理判断不一致的情况。其余39例患者进行数据分析。
作为预处理检查，对脑部进行计算机断层扫描（CT）的有8例，颈部39例，胸部32例；对脑部进行磁共振成像（MRI）的有4例，颈部23例；23例患者进行了正电子发射断层扫描-CT（PET-CT），4例进行了骨闪烁显像，9例进行了颈部超声检查，25例检测了肿瘤标志物。原发部位为口腔1例、鼻腔/鼻窦16例、鼻咽2例、口咽4例、下咽2例、喉6例、唾液腺3例、甲状腺2例及其他3例。分期为II/III/IV-A/IV-B/IV-C/未确定分别为3/5/16/6/5/4例；IV期占69%。无患者发生脑转移。一线治疗分为3组：放化疗（CRT）组27例、非CRT组8例、最佳支持治疗组4例。CRT组包括同步放化疗（CCRT）17例、化疗（Chemo）后放疗（RT）5例、手术（Surg）后CCRT 5例。非CRT组包括Surg后RT 2例、Surg后Chemo 1例、单纯RT 2例、单纯Chemo 3例。39例患者的1年/2年总生存率（OS）为65.3%/53.3%。CRT组的1年OS（77.6%）显著优于非CRT组（31.3%）。CCRT组（22例）与非同步RT的化疗组（9例）之间不良事件无显著差异。
颈部和胸部CT、颈部MRI及PET-CT在HNSmCC的诊断检查中是必要且充分的。CCRT可推荐作为一线治疗。1年/2年OS为65.3%/53.3%。本研究将为提出HNSmCC的诊断和治疗算法提供基础数据。
