Extra-pulmonary small cell carcinoma in the head and neck setting: the role of prophylactic cranial irradiation

Matthew Mason; Meredith Giuliani; Shao Hui Huang; Wei Xu; Andrew Hope; John Kim; Andrew Bayley; B C John Cho; David Goldstein; Raymond W Jang; Bayardo Perez Ordonez; Sandra Wajstaub; John Waldron; Robert Dinniwell; Brian O'Sullivan; Jolie Ringash

doi:10.1016/j.oraloncology.2015.03.014

Extra-pulmonary small cell carcinoma in the head and neck setting: the role of prophylactic cranial irradiation

Oral Oncol. 2015 Jun;51(6):e57-9. doi: 10.1016/j.oraloncology.2015.03.014. Epub 2015 Apr 10.

Authors

Affiliations

¹ Department of Radiation Oncology, Princess Margaret Cancer Centre/University Health Network, University of Toronto, Toronto, ON M5T 2M9, Canada.
² Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5T 2M9, Canada.
³ Department of Department of Otolaryngology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON, Canada M5T 2M9.
⁴ Division of Medical Oncology, Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5T 2M9, Canada.
⁵ Department of Pathology, University Health Network, University of Toronto, Toronto, ON M5T 2M9, Canada.
⁶ Department of Radiation Oncology, Cape Breton Cancer Centre, 1482 George Street, Sydney, NS B1P 1P3, Canada.

PMID: 25865552
DOI: 10.1016/j.oraloncology.2015.03.014

Abstract

Head-and-neck small cell carcinoma (HN-SmCC) is a rare entity and there is limited data to support management decisions. The role of prophylactic cranial irradiation (PCI) remains controversial. A retrospective review of 21 consecutive HN-SmCCs was performed. No case received PCI. The 2-year overall survival, local, regional and distant control rates were 65%, 94%, 88%, and 76% respectively. Despite no patient receiving PCI, brain metastases were uncommon (n=2) and routine use of PCI is not justified in this population.

Keywords: Brain metastases; Chemoradiotherapy; Head and neck carcinoma; IMRT; Local failure; Neurocognition; Patterns of failure; Prophylactic cranial irradiation; Small cell carcinoma; Whole brain radiation.

Publication types

Letter
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Brain Neoplasms / secondary
Carcinoma, Small Cell / mortality*
Carcinoma, Small Cell / secondary
Carcinoma, Small Cell / therapy*
Cranial Irradiation / statistics & numerical data*
Female
Head and Neck Neoplasms / mortality*
Head and Neck Neoplasms / pathology
Head and Neck Neoplasms / therapy*
Humans
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate