Analysis Of10Upper Respiratory Tract Neuroendocrine Caecinoma Cases And Review Of The Literature

Objective: Primary neuroendocrine carcinoma of the upper respiratorytract is very rare.Few systematic researchers has studied on theirdiagnosis,treatment and prognosis.This paper explores the diagnosistreatment and prognosis of primary neuroendocrine carcinoma of the upperrespiratory tract, in order to improve the knowledge of the diagnosis andtreatment of such diseases.Methods: The clinical data and prognosis of10upper respiratoryneuroendocrine carcinoma cases(6cases of larynx neuroendocrinecarcinoma, four cases of nasal cavity and paranasal sinus neuroendocrinecarcinoma) were analyzed retrospectively. All the10cases was admitted onJanuary1,2006to February30,2013, in the First Affiliated Hospital ofChongqing Medical University, Chongqing Cancer Hospital. Patients’ initialtreatment: three cases accepted adjuvant radiotherapy chemotherapy, threeaccepted tumor resection combined Chemoradiotherapy, one cases acceptedtumor resection combined radiotherapy, one case accepted conventionalradiotherapy only, one case accepted2course of chemotherapy after tumor resection then gave up treatment. After the initial treatment, two patientswho suffered laryngeal neuroendocrine carcinoma accepted secondaryradical operation due to local recurrence.Review the related publishedliterature,and summarized the diagnosis,treatment and prognosis of thisdisease.Results: From the date of definitive diagnosis to the follow-upendpoint (time of death or February30,2013),9patients were followed upfor3months-39months (remove one cases who is still under treatment tillthe endpoint).3patients who accepted tumor resection combinedChemoradiotherapy suffered small cell neuroendocrine carcinoma:2patients without recurrence,1patient got distant metastasis after secondaryradical operation(local recurrence after initial treatment);3patients whoaccepted Chemoradiotherapy suffered small cell neuroendocrine carcinoma:1patient develop dysphagia and cachexia after6months of initialtreatment,1patient died within3month,1patient is under treatment;1patient accepted tumor resection combined radiotherapy suffered laryngealatypical carcinoid,got local recurrence after34months,then acceptedradical operation,without secondary recurrence;1patient who gotconventional radiotherapy only survival with tumor;1patient who accepted2course of chemotherapy after tumor resection then gave up treatment diedwithin7months;1patient who gave up therapy died.Of all the patients,thelongest survival time is39months, the longest recurrence-free survival time is34months, the shortest survival time is only3months. The mediansurvival time is9month.The average survival time is12.2months.Conclusion: The upper respiratory tract neuroendocrine carcinoma israre, with poor prognosis, easy recurrence and metastasis. The choice oftherapy method of Laryngeal neuroendocrine cancer is closely related totumor pathology classification: laryngeal typical carcinoid better treated bytumor resection only; the atypical carcinoid better treated by tumorresection, whether combined adjuvant radiotherapy or chemotherapy,depending on the patients’ condition; small cell neuroendocrine carcinomabetter treated by the combined therapy of surgical adjuvantchemoradiation.For nasal cavity and paranasal sinus neuroendocrinecarcinoma,the small cell carcinoma is the most common,and surgerycombined with chemoradiation can obtain a certain effect.