Head and Neck TumorsHead and Neck TumorsОпухоли головы и шеи2222-14682411-4634Publishing House ABV Press67910.17650/2222-1468-2021-11-3-109-114CASE REPORTКЛИНИЧЕСКИЙ СЛУЧАЙInduction chemotherapy with docetaxel and doxorubicin followed by proton beam radiation therapy for platinum-resistant unresectable sinonasal undifferentiated carcinomaИндукционная химиотерапия с включением доцетаксела и доксорубицина и последующей протонной лучевой терапией при платинорезистентной нерезектабельной синоназальной недифференцированной карциномеhttps://orcid.org/0000-0001-5530-3234KachmazovA. A.КачмазовА. А.
Russian Federation

Andrei Aleksandrovich Kachmazov

3 2nd Botkinsky Dr., Moscow 125284

Андрей Александрович Качмазов

125284 Москва, 2‑й Боткинский пр-д, 3

andrewkachmazov@gmail.comhttps://orcid.org/0000-0003-4879-2687BolotinaL. V.БолотинаЛ. В.
Russian Federation

3 2nd Botkinsky Dr., Moscow 125284

125284 Москва, 2‑й Боткинский пр-д, 3

https://orcid.org/0000-0003-0092-0459KornietskayaA. L.КорниецкаяА. Л.
Russian Federation

3 2nd Botkinsky Dr., Moscow 125284

125284 Москва, 2‑й Боткинский пр-д, 3

https://orcid.org/0000-0001-6917-6520TolstovV. A.ТолстовВ. А.
Russian Federation

5 2nd Botkinsky Dr., Moscow 125284

125284 Москва, 2‑й Боткинский пр-д, 5

FedenkoA. A.ФеденкоА. А.
Russian Federation

3 2nd Botkinsky Dr., Moscow 125284

125284 Москва, 2‑й Боткинский пр-д, 3

P. A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of RussiaМосковский научно-исследовательский институт онкологии им. П. А. Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава РоссииS.P. Botkin City Clinical HospitalГБУ «Городская клиническая больница им. С. П. Боткина»121120211131091141211202112112021Copyright ©; 2021, Kachmazov A.A., Bolotina L.V., Kornietskaya A.L., Tolstov V.A., Fedenko A.A.Copyright ©; 2021, Качмазов А.А., Болотина Л.В., Корниецкая А.Л., Толстов В.А., Феденко А.А.2021Kachmazov A.A., Bolotina L.V., Kornietskaya A.L., Tolstov V.A., Fedenko A.A.Качмазов А.А., Болотина Л.В., Корниецкая А.Л., Толстов В.А., Феденко А.А.https://creativecommons.org/licenses/by/4.0https://ogsh.abvpress.ru/jour/article/view/679

Sinonasal undifferentiated carcinoma is a rare and aggressive tumor with an extremely poor prognosis. In the vast majority of cases, this tumor can not be resected due to its rapid local growth. Correct morphological diagnosis is impossible without a thorough differential diagnosis between sinonasal undifferentiated carcinoma and a number of lowgrade tumors of the nasal cavity and paranasal sinuses. Very few case reports and retrospective studies on sinonasal undifferentiated carcinoma have been published so far. No unified widely accepted guidelines on sinonasal undifferentiated carcinoma treatment are currently available due to the lack of statistically significant data from randomized clinical trials. The optimal treatment strategy should be based on an aggressive multimodal approach involving radical surgery, precision radiation therapy, and intensive chemotherapy. The benefits of systemic targeted therapy for patients with sinonasal undifferentiated carcinoma are still unclear. The best results can be achieved by employing tailored treatment approaches preferably in multidisciplinary cancer centers, where healthcare professionals experienced in managing patients with head and neck tumors can be involved. In this article, we report a case of complete radiological response after induction chemotherapy with docetaxel and doxorubicin and proton radiation therapy for the primary tumor area in a 53‑year-old female patient with non-resectable platinum-resistant sinonasal undifferentiated carcinoma.

Синоназальная недифференцированная карцинома представляет собой редкое и агрессивное новообразование и имеет крайне неблагоприятный прогноз. В подавляющем большинстве случаев данная опухоль исходно нерезектабельна в связи с характерным для нее быстрым локальным ростом. Постановка верного морфологического диагноза невозможна без тщательной дифференциальной диагностики ряда низкодифференцированных опухолей полости носа и околоносовых пазух. В литературе описаны лишь единичные клинические наблюдения и приведены результаты небольшого количества ретроспективных исследований. В связи с отсутствием статистически значимых данных, полученных в рамках рандомизированных клинических исследований, в настоящий момент не существует общепризнанных рекомендаций по лечению синоназальной недифференцированной карциномы. Оптимальной стратегией лечения данного заболевания представляется использование агрессивного мультимодального подхода, предполагающего применение радикальной хирургии, прецизионной лучевой терапии и интенсивной химиотерапии. Возможности таргетного системного воздействия при синоназальной недифференцированной карциноме по‑прежнему практически не изучены. В настоящий момент наилучшие результаты могут быть достигнуты при применении индивидуального подхода к лечению, предпочтительно в условиях многопрофильных онкологических центров с участием опытных специалистов в области онкологических заболеваний головы и шеи. В данной статье мы представляем клинический случай достижения полного радиологического ответа после индукционной химиотерапии с включением доцетаксела и доксорубицина и протонной лучевой терапии на область первичной опухоли у 53‑летней пациентки с исходно нерезектабельной платинорезистентной синоназальной недифференцированной карциномой.  

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