METHODS: Between Nov 2000 and Nov 2021, ninety-three patients diagnosed with neuroendocrine neoplasms of head and neck treated at our institution were reviewed retrospectively. The initial treatments included chemotherapy (induction, adjuvant, or concurrent) combined with radiotherapy in 40 patients (C + RT group), surgery followed by post-operative RT in 34 (S + RT group), and surgery plus salvage therapy in 19 patients (S + Sa group).
RESULTS: The median follow-up time was 64.5 months. 5-year overall survival rate (OS), progression-free survival rate (PFS), loco-regional relapse-free survival free rate (LRRFS) and distant metastasis-free survival rate (DMFS) were 64.5%, 51.6%, 66.6%, and 62.1%, respectively. For stage I-II, the 5-year LRRFS for patients\' treatment regimen with or without radiotherapy (C + RT and S + RT groups versus S + Sa group) was 75.0% versus 12.7% (p = 0.015) while for stage III-IV, the 5-year LRRFS was 77.8% versus 50.0% (p = 0.006). The 5-year DMFS values for patients with or without systemic therapy (C + RT group versus S + RT or S + Sa) were 71.2% and 51.5% (p = 0.075). 44 patients (47.3%) experienced treatment failure and distant metastasis was the main failure pattern.
CONCLUSIONS: Radiotherapy improved local-regional control and played an important role in the management of HNNENs. The optimal treatment regimen for HNNENs remains the combination of local and systemic treatments.
方法:在2000年11月至2021年11月之间,回顾性分析了在我们机构治疗的93例诊断为头颈部神经内分泌肿瘤的患者。最初的治疗包括化疗(诱导,佐剂,或同时)联合放疗40例患者(C+RT组),34例(S+RT组)手术后接受RT,手术加抢救治疗19例(S+Sa组)。
结果:中位随访时间为64.5个月。5年总生存率(OS),无进展生存率(PFS),无局部复发生存率(LRRFS)和无远处转移生存率(DMFS)分别为64.5%,51.6%,66.6%,和62.1%,分别。对于I-II阶段,有或没有放疗的患者的5年LRFS治疗方案(C+RT和S+RT组对S+Sa组)为75.0%对12.7%(p=0.015),而III-IV期,5年LRRFS分别为77.8%和50.0%(p=0.006)。有或没有全身治疗的患者的5年DMFS值(CRT组与SRT或SSa)分别为71.2%和51.5%(p=0.075)。44例(47.3%)患者出现治疗失败,远处转移是主要失败模式。
结论:放射治疗改善了局部区域控制,在HNNENs的管理中发挥了重要作用。HNNENs的最佳治疗方案仍然是局部和全身治疗的组合。