Geng Xiaotao, Chang Xiaolong, Wang Xiaoli, Li Shunjia, Han Guiyan, Song Zhiyu, Hao Furong, Li Jianwen
Department of Radiation Oncology, Weifang People's Hospital, Weifang, China.
Department of Pathology, Weifang People's Hospital, Weifang, China.
Front Oncol. 2024 Dec 6;14:1368187. doi: 10.3389/fonc.2024.1368187. eCollection 2024.
Nuclear protein in testis (NUT) cancers, also known as midline cancers, tends to occur in organs near the midline, such as the nasal sinuses and mediastinum. NUT carcinoma is very rare and has a poor prognosis.
We report the case of a 44-year-old female patient with sinonasal NUT carcinoma who presented with a soft tissue mass in the left frontal sinus, ethmoid sinus, and left nasal cavity on computed tomography; the tumor was poorly demarcated from the left rectus medialis. After discussion with a multidisciplinary team with expertise on head and neck tumors, the patient was considered inoperable, and definitive concurrent chemoradiotherapy (CCRT) was recommended. The patient underwent CCRT followed by three cycles of consolidation chemotherapy with albumin-bound paclitaxel and nedaplatin. Subsequently, the patient underwent 16 cycles of consolidation therapy with the programmed death-1 (PD-1) inhibitor tislelizumab. The immune-related adverse events included grade 2 hypothyroidism. After CCRT, consolidation chemotherapy, and consolidation immunotherapy, the patient achieved a favorable outcome. The patient survived for 31 months, and there were no signs of recurrence or metastasis during follow-up.
At present, there is no clear consensus on the consolidation treatment plan after CCRT for sinonasal NUT cancer. We used consolidation immunotherapy for the first time and achieved good efficacy, providing an innovative and promising treatment plan for refractory sinonasal NUT cancer.
睾丸核蛋白（NUT）癌，也称为中线癌，倾向于发生在中线附近的器官，如鼻窦和纵隔。NUT癌非常罕见，预后较差。
我们报告了一例44岁女性鼻窦NUT癌患者，计算机断层扫描显示左侧额窦、筛窦和左侧鼻腔有软组织肿块；肿瘤与左侧内直肌分界不清。在与头颈肿瘤多学科专家团队讨论后，认为该患者无法手术，建议进行确定性同步放化疗（CCRT）。患者接受了CCRT，随后接受了三个周期的白蛋白结合型紫杉醇和奈达铂巩固化疗。随后，患者接受了16个周期的程序性死亡-1（PD-1）抑制剂替雷利珠单抗巩固治疗。免疫相关不良事件包括2级甲状腺功能减退。经过CCRT、巩固化疗和巩固免疫治疗后，患者取得了良好的疗效。患者存活了31个月，随访期间无复发或转移迹象。
目前，鼻窦NUT癌CCRT后的巩固治疗方案尚无明确共识。我们首次使用巩固免疫治疗并取得了良好疗效，为难治性鼻窦NUT癌提供了一种创新且有前景的治疗方案。
