Comparison of chemotherapy for unresectable pulmonary high-grade non-small cell neuroendocrine carcinoma and small-cell lung cancer

• Published in: Lung cancer (Amsterdam, Netherlands) Vol. 68; no. 3; pp. 438 - 445
• Main Authors: Igawa, Satoshi, Watanabe, Reiko, Ito, Ichiro, Murakami, Haruyasu, Takahashi, Toshiaki, Nakamura, Yukiko, Tsuya, Asuka, Kaira, Kyoichi, Naito, Tateaki, Endo, Masahiro, Yamamoto, Nobuyuki, Kameya, Toru
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ireland Ltd 01.06.2010; Elsevier
• Subjects: Aged; Aged, 80 and over; Biological and medical sciences; Camptothecin - administration & dosage; Camptothecin - adverse effects; Camptothecin - analogs & derivatives; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - physiopathology; Chemotherapy; Disease Progression; Drug Therapy, Combination; Female; Hematology, Oncology and Palliative Medicine; High-grade non-small cell neuroendocrine carcinoma; Humans; Immunohistochemistry; Lung Neoplasms - diagnosis; Lung Neoplasms - drug therapy; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - physiopathology; Male; Medical sciences; Middle Aged; Neoplasm Staging; Neuroendocrine Tumors - diagnosis; Neuroendocrine Tumors - drug therapy; Neuroendocrine Tumors - mortality; Neuroendocrine Tumors - pathology; Neuroendocrine Tumors - physiopathology; Platinum Compounds - administration & dosage; Platinum Compounds - adverse effects; Pneumology; Pulmonary/Respiratory; Small cell lung cancer; Survival Analysis; Taxoids - administration & dosage; Taxoids - adverse effects; Tumors; Tumors of the respiratory system and mediastinum; Vinblastine - administration & dosage; Vinblastine - adverse effects; Vinblastine - analogs & derivatives; Small cell lung cancer; Chemotherapy; High-grade non-small cell neuroendocrine carcinoma; High; Respiratory disease; Lung; Malignant tumor; Treatment; Cancerology; Unresectable; Small cell carcinoma; Comparative study; Cancer; Non small cell carcinoma; Pneumology
• ISSN: 0169-5002; 1872-8332
• DOI: 10.1016/j.lungcan.2009.07.003

Abstract Background Pulmonary large cell neuroendocrine carcinoma (LCNEC) shares several features with small cell lung carcinoma (SCLC). Most histologic diagnoses of LCNEC are currently obtained by surgical specimens. While the diagnosis of LCNEC by biopsy specimens is challenging, a definitive diagnosis of this highly malignant tumor is critical in unresectable cases to determine the optimal therapeutic strategy. The objective of this study was to assess the efficacy of chemotherapy for unresectable high-grade non-small cell neuroendocrine carcinoma (HNSCNEC) called by us, which likely includes most LCNECs except for combined types, and to compare the efficacy of chemotherapy for HNSCNEC, with that for extended disease SCLC (ED-SCLC). Methods Between September 2002 and October 2007, we reviewed 14 patients with HNSCNEC, which was defined using biopsy specimens according to histological and immunohistological criteria proposed by us. We simultaneously evaluated the clinical response to the chemotherapy and survival time of the 14 HNSCNEC and 77 ED-SCLC patients. Results The chemotherapy regimens in the 14 patients with unresectable HNSCNEC were platinum-based combination regimens or irinotecan or vinorelbine or docetaxel alone. The chemotherapy regimens in the 77 patients with ED-SCLC were platinum-based combination regimens. We assessed an objective response rate, a one-year survival rate, and median survival time as 50% (7/14), 34% and 10 months, respectively, in the 14 HNSCNEC patients, and as 53% (41/77), 48% and 12.3 months, respectively, in the 77 ED-SCLC patients. Conclusion The clinical efficacy of chemotherapy for unresectable HNSCNECs, including most LCNECs, is comparable to that for ED-SCLC.