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Multimodality treatment for poorly differentiated neuroendocrine head and neck carcinomas--a single institution
1Department for Hematology, Oncology and Palliative Care, Academic Teaching Hospital Bielefeld, Bielefeld, Germany. martin.goerner@klinikumbielefeld.de
Abstract:
Poorly differentiated head and neck neuroendocrine neoplasms are very rare. Surgical resection alone is insufficient to control the disease because of the high incidence of metastases. However, due to the lack of randomised clinical trials, treatment recommendations for this cancer vary considerably and are based on a limited number of small retrospective studies. We performed a retrospective analysis of all patients treated at our institution between 2003 and 2011. We assessed the stage of disease, type of therapy, toxicity, treatment response, time to progression and overall survival for all cases. Ten patients received combined modality treatment with chemotherapy in addition to surgery or radiation or both. According to Response Evaluation Criteria In Solid Tumours (RECIST) criteria, six of nine evaluable patients achieved complete remission and three patients had a partial remission. The mean duration of response was 358 days, with a range from 141 to 1080 days. The overall 1-year survival rate was 88%; however, only approximately 50% of patients were alive after 2 years. Multimodality treatment concepts induce high initial remission rates in poorly differentiated neuroendocrine head and neck carcinomas. However, the time to relapse is usually short, and therefore long-term prognosis of this rare head and neck tumour remains poor.
Insights
Multimodality treatment offers high remission rates for rare poorly differentiated head and neck neuroendocrine neoplasms. However, prognosis remains poor due to short relapse times and limited long-term survival.
Area of Science:
- Oncology
- Head and Neck Surgery
- Neuroendocrine Tumors
Background:
- Poorly differentiated head and neck neuroendocrine neoplasms are rare and aggressive.
- Surgical resection alone is often insufficient due to high metastatic potential.
- Limited clinical trials lead to varied treatment recommendations.
Purpose of the Study:
- To evaluate the efficacy of multimodality treatment for poorly differentiated head and neck neuroendocrine neoplasms.
- To analyze treatment response, progression, and survival in these rare tumors.
Main Methods:
- Retrospective analysis of 10 patients treated between 2003 and 2011.
- Combined modality treatment including chemotherapy, surgery, and/or radiation.
- Assessment of disease stage, therapy, toxicity, response (RECIST criteria), time to progression, and survival.
Main Results:
- Six of nine evaluable patients achieved complete remission; three had partial remission.
- Mean duration of response was 358 days (range: 141-1080 days).
- 1-year survival rate was 88%, but 2-year survival was approximately 50%.
Conclusions:
- Multimodality treatment achieves high initial remission rates in these rare cancers.
- Short time to relapse indicates a poor long-term prognosis.
- Further research is needed for improved therapeutic strategies.
