Small Cell Carcinoma of the Head and Neck: the University of Florida Experience

Objective: To describe the University of Florida experience in treating small cell carcinoma of the head and neck with radiotherapy as the primary local treatment modality. Materials and Methods: Five patients with small cell carcinoma of the head and neck were treated definitively with radiotherapy between November 1989 and September 2001. Neoadjuvant chemotherapy was used in 4 of the 5 patients. Chemotherapy was followed by definitive radiotherapy to a median dose of 65.5 Gy. Results: Only 1 of the 5 patients survived longer than 13 months. He remains free of disease 3 years after neoadjuvant carboplatin and paclitaxel chemotherapy and radiotherapy to 74.4 Gy at 1.2 Gy per fraction twice daily. Regional or distant disease accounted for the majority of failures. One local recurrence occurred in a patient with a T4 laryngeal primary tumour. Conclusions: Radiotherapy is a reasonable alternative to surgery for patients with early- and moderate-stage small cell carcinoma of the head and neck. Although the addition of surgery might improve local and regional control for patients with more advanced disease, the potential benefit may be offset by the high risk of distant failure. More effective systemic chemotherapy is necessary to improve the outcome for these patients.