RESUMO
AIMS: Adenoid cystic carcinoma (ACC) is a rare tumour that usually arises in the salivary glands. Initial management is surgery often combined with adjuvant radiotherapy. Chemotherapy is reserved for treatment of symptomatic recurrence. We evaluated the combination of epirubicin, cisplatin and protracted venous infusion 5-fluorouracil (ECF) in the management of ACC. MATERIALS AND METHODS: Patients referred for treatment of advanced, symptomatic ACC were considered. The drugs given were epirubicin 50 mg/m(2) 3-weekly, cisplatin 60 mg/m(2) 3-weekly and protracted venous infusion 5-fluorouracil 200 mg/m(2)/day. RESULTS: Eight patients (median age 46 years) received a median of five cycles of chemotherapy. All patients had had previous surgery, seven had had previous radiotherapy and one had had previous chemotherapy. One patient showed a partial response (duration 34 months) and five showed stable disease (median duration 13.6 months [6.8-15.9+ months]). Median survival was 27 months (3.5-62.3 months). CONCLUSIONS: The activity of ECF in ACC of the head and neck seems to be similar to the combination of cisplatin and 5-fluorouracil and single-agent epirubicin.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Adenoide Cístico/tratamento farmacológico , Neoplasias das Glândulas Salivares/tratamento farmacológico , Adulto , Antibióticos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/administração & dosagem , Carcinoma Adenoide Cístico/mortalidade , Cisplatino/administração & dosagem , Progressão da Doença , Epirubicina/administração & dosagem , Feminino , Fluoruracila/administração & dosagem , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Salivares/mortalidade , Análise de SobrevidaRESUMO
Metastasis to the thyroid gland is rare, with fewer than 450 cases reported in the literature. Furthermore, intrathyroid metastasis from head and neck squamous cell carcinoma (HNSCC) is even more unusual, with only nine previously documented cases. This study details the cases of three patients (from one centre) who presented with intrathyroid metastasis from HNSCC and who were treated with a combination of surgery and radiotherapy. Although previous reports have suggested that this pattern of spread is associated with a poor outcome, we are able to show that appropriately selected patients benefit from a combination of both radical surgery and adjuvant radiation therapy, even when this entails some areas of re-irradiation.