[Clinical analysis of small cell neuroendocrine carcinoma of the head and neck].
OBJECTIVE
To seek a best therapeutic protocol for small cell neuroendocrine carcinoma of head and neck.


METHODS
The clinical data of 34 patients with small cell neuroendocrine carcinoma of head and neck, 21 males and 13 females, aged 53 (17 - 71), were retrospectively analyzed. The therapeutic protocols that had been used for the patients included surgery alone (in 5 patients), radiotherapy alone (in 7 patients), combined therapy with surgery and radiotherapy (in 7 patients), combined therapy with surgery and chemotherapy (for 3 patients), combined therapy with radiotherapy and chemotherapy (for 10 patients), and combined therapy with surgery, radiotherapy and chemotherapy (for 2 patients). The follow-up ended on August 1 2007.


RESULTS
The prognosis of the patient with small cell neuroendocrine carcinoma of skin was the best. Local recurrence occurred in 7 patients, of which 2 underwent surgery alone, 2 combined therapy with surgery and radiotherapy, 1 combined therapy with surgery and chemotherapy, and 2 combined therapy with radiotherapy and chemotherapy. Recurrence in neck occurred in 1 patient that had undergone combined therapy with surgery and radiotherapy. Neck lymph node metastasis was found in 4 patients of whom 2 had undergone surgery alone, 1 had undergone combined therapy with surgery and chemotherapy, and 1 combined therapy with radiotherapy and chemotherapy. Distant metastasis was found in 11 patients of whom 2 had undergone surgery alone, 2 radiotherapy alone, 3 combined therapy with surgery and radiotherapy, and 3 combined therapy with radiotherapy and chemotherapy. The median survival time was 24 months, and the overall 3-year and 5-year cumulative survival rates were 65.37% and 35.95% respectively.


CONCLUSIONS
The prognosis of the patient with small cell neuroendocrine carcinoma of head and neck was poor. Small cell neuroendocrine carcinoma cases with the lesions at different sites differ in prognosis and needed different therapeutic fashions. Combined therapy with radiotherapy and chemotherapy is recommended for small cell neuroendocrine carcinoma of head and neck, and surgery serves as a salvage therapeutic measure.
Li
Zheng-jiang
ZJ
Department of Head and Neck Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021, China. lzjmed@yahoo.com.cn
Li
Hui-zheng
HZ
Liu
Wen-sheng
WS
Xu
Zhen-gang
ZG
Tang
Ping-zhang
PZ
D000293:Adolescent; D000328:Adult; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate