Chemotherapy as treatment of choice in extrapulmonary undifferentiated small cell carcinomas

The first description of an extrapulmonary small-cell carcinoma (cancer) appeared in 1930. Since that time, this small-cell carcinoma has come to be increasingly recognized as a distinct clinical entity. The tissues most often involved are the salivary glands, pharynx, larynx, esophagus, stomach, colon, rectum, and cervix. Though some small-cell carcinomas are slow to progress, small-cell carcinomas of the pharynx, esophagus, and paranasal sinuses are rapidly progressive, and untreated patients typically die quickly. In a study involving 11 patients, several chemotherapeutic protocols were used in an attempt to induce remission. Nine patients, including all those who were to achieve complete response or long-term survival, received intravenous doxorubicin, cyclophosphamide, and etoposide. Six patients achieved a complete response to the chemotherapy; five of those six had limited disease. It is worth noting that in two patients with metastatic small-cell carcinoma of the cervical lymph nodes, prolonged survival was observed although the primary tumor could not be located. These two patients remained disease-free at the 12- and 22-month follow-ups. The overall median survival rate was 12 months. Long-term survival was achieved in four of the five patients with limited disease. Chemotherapy appears to be the treatment of choice, with additional radiation therapy indicated in some patients. (Consumer Summary produced by Reliance Medical Information, Inc.)