Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2019; 7(6): 765-772
Published online Mar 26, 2019. doi: 10.12998/wjcc.v7.i6.765
Induction chemotherapy with docetaxel, cisplatin and fluorouracil followed by concurrent chemoradiotherapy for unresectable sinonasal undifferentiated carcinoma: Two cases of report
Sho Watanabe, Yoshitaka Honma, Naoya Murakami, Hiroshi Igaki, Taisuke Mori, Hidekazu Hirano, Natsuko Okita, Hirokazu Shoji, Satoru Iwasa, Atsuo Takashima, Ken Kato, Kenya Kobayashi, Fumihiko Matsumoto, Seiichi Yoshimoto, Jun Itami, Narikazu Boku
Sho Watanabe, Yoshitaka Honma, Narikazu Boku, Department of Head and Neck Medical Oncology, National Cancer Center Hospital, Tokyo 1040045, Japan
Naoya Murakami, Hiroshi Igaki, Jun Itami, Department of Radiation Oncology, National Cancer Center Hospital, Tokyo 1040045, Japan
Taisuke Mori, Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo 1040045, Japan
Hidekazu Hirano, Natsuko Okita, Hirokazu Shoji, Satoru Iwasa, Atsuo Takashima, Ken Kato, Department of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo 1040045, Japan
Kenya Kobayashi, Fumihiko Matsumoto, Seiichi Yoshimoto, Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo 1040045, Japan
Author contributions: Watanabe S, Honma Y, Murakami N, Igaki H, Kobayashi K and Matsumoto F were responsible for the patient care. Honma Y designed the study. Mori T performed the pathological review. All authors contributed to the manuscript preparation.
Informed consent statement: Informed consent was obtained from the patients for whom identifying information is included in this article.
Conflict-of-interest statement: All authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yoshitaka Honma, MD, Chief Doctor, Department of Head and Neck Medical Oncology, National Cancer Center Hospital, 1-1, Tsukiji 5, Chuo-ku, Tokyo 1040045, Japan. yohonma@ncc.go.jp
Telephone: +81-3-35422511
Received: November 23, 2018
Peer-review started: November 23, 2018
First decision: January 12, 2019
Revised: January 27, 2019
Accepted: February 26, 2019
Article in press: February 26, 2019
Published online: March 26, 2019
Processing time: 123 Days and 11 Hours
Abstract
BACKGROUND

Sinonasal undifferentiated carcinoma (SNUC) is a rare aggressive tumor that is often unresectable. Optimal treatment for patients with unresectable, locally advanced SNUC (LA-SNUC) has not been established, and the patient outcome remains poor. We report two cases of unresectable LA-SNUC in which induction chemotherapy with docetaxel, cisplatin and fluorouracil (TPF) followed by radiotherapy with concurrent cisplatin (CCRT), a standard treatment option for locally advanced head and neck cancer, demonstrated promising outcomes.

CASE SUMMARY

A 39-year-old man presented with tearing and pain in the right eye. A biopsy of the tumor invading the sinonasal cavities, right orbit and cranial base confirmed the diagnosis of LA-SNUC. Induction TPF chemotherapy induced remarkable tumor shrinkage and rapidly improved the symptoms. He subsequently received CCRT and achieved complete remission of the disease. The other case is a 21-year-old man who presented with worsening vision. The unresectable tumor involving the nasal septum and cranial base was pathologically diagnosed as SNUC. TPF chemotherapy followed by CCRT yielded complete remission of the disease with preserved visual function. Both patients have been disease-free for 44 mo.

CONCLUSION

Induction TPF chemotherapy followed by CCRT may remarkably improve the outcomes in LA-SNUC patients.

Keywords: Sinonasal undifferentiated carcinoma; Chemotherapy with docetaxel, cisplatin and fluorouracil chemotherapy; Docetaxel; Cisplatin; Fluorouracil; Intensity-modulated radiotherapy; Chemoradiotherapy; Case report

Core tip: Sinonasal undifferentiated carcinoma easily invades adjacent organs and is often diagnosed in unresectable disease. Though multimodality treatment has been developed, there is no standard of care for locally advanced Sinonasal undifferentiated carcinoma (LA-SNUC) and the patient outcome remains dismal. We report two cases of unresectable LA-SNUC in which induction chemotherapy with docetaxel, cisplatin and fluorouracil (TPF) followed by cisplatin-based concurrent chemoradiotherapy (CCRT) rapidly improved symptoms and yielded durable complete remission. Together with review of literature, our cases show that TPF chemotherapy followed by CCRT, a standard treatment for locally advanced head and neck cancer, should be more encouraged for unresectable LA-SNUC.