title: Head and neck region consolidation radiotherapy and prophylactic cranial irradiation with hippocampal avoidance delivered with helical tomotherapy after induction chemotherapy for non-sinonasal neuroendocrine carcinoma of the upper airways.
abstract: BACKGROUND
  Non-sinonasal neuroendocrine carcinomas (NSNECs) of the head and neck are considered an unfrequent clinico-pathological entity. Combined modality treatment represents an established therapeutic option for undifferentiated forms where distant metastasis is a common pattern of failure.
  
  
  METHODS
  We report on a case of NSNEC treated with sequential chemo-radiation consisting of 6 cycles of cisplatin and etoposide followed by loco-regional radiation to the head and neck and simultaneous prophylactic cranial irradiation to prevent from intracranial spread, delivered with helical tomotherapy with the 'hippocampal avoidance' technique in order to reduce neuro-cognitive late effects.
  
  
  RESULTS
  One year after the end of the whole combined modality approach, the patient achieved complete remission, with no treatment-related sub-acute and late effects.
  
  
  CONCLUSIONS
  The present report highlights the importance of multidisciplinary management for NSNECs of the head and neck, as the possibility to achieve substantial cure rates with mild side effects with modern radiotherapy techniques.
authors.affiliation: Radiation Oncology Department, Tomotherapy Unit, Ospedale Regionale U,Parini, AUSL Valle d'Aosta, Viale Ginevra n° 3, 11100 Aosta, Italy. pfranco@ausl.vda.it
authors.forename: Pierfrancesco
authors.initials: P
authors.lastname: Franco
authors.forename: Gianmauro
authors.initials: G
authors.lastname: Numico
authors.forename: Fernanda
authors.initials: F
authors.lastname: Migliaccio
authors.forename: Paola
authors.initials: P
authors.lastname: Catuzzo
authors.forename: Domenico
authors.initials: D
authors.lastname: Cante
authors.forename: Paola
authors.initials: P
authors.lastname: Ceroni
authors.forename: Piera
authors.initials: P
authors.lastname: Sciacero
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Carassai
authors.forename: Paolo
authors.initials: P
authors.lastname: Canzi
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: La Porta
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Girelli
authors.forename: Valeria Casanova
authors.initials: VC
authors.lastname: Borca
authors.forename: Massimo
authors.initials: M
authors.lastname: Pasquino
authors.forename: Santi
authors.initials: S
authors.lastname: Tofani
authors.forename: Franca
authors.initials: F
authors.lastname: Ozzello
authors.forename: Umberto
authors.initials: U
authors.lastname: Ricardi
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage; D016371:Cranial Irradiation; D005047:Etoposide / Q000008:administration & dosage; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006624:Hippocampus; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments; D012074:Remission Induction; D012142:Respiratory Tract Neoplasms / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005047:Etoposide; D002945:Cisplatin