Table 1_Consolidation immunotherapy following concurrent chemoradiotherapy in a patient with sinonasal NUT carcinoma: a case report.docx

BackgroundNuclear protein in testis (NUT) cancers, also known as midline cancers, tends to occur in organs near the midline, such as the nasal sinuses and mediastinum. NUT carcinoma is very rare and has a poor prognosis.
Case descriptionWe report the case of a 44-year-old female patient with sinonasal NUT carcinoma who presented with a soft tissue mass in the left frontal sinus, ethmoid sinus, and left nasal cavity on computed tomography; the tumor was poorly demarcated from the left rectus medialis. After discussion with a multidisciplinary team with expertise on head and neck tumors, the patient was considered inoperable, and definitive concurrent chemoradiotherapy (CCRT) was recommended. The patient underwent CCRT followed by three cycles of consolidation chemotherapy with albumin-bound paclitaxel and nedaplatin. Subsequently, the patient underwent 16 cycles of consolidation therapy with the programmed death–1 (PD-1) inhibitor tislelizumab. The immune-related adverse events included grade 2 hypothyroidism. After CCRT, consolidation chemotherapy, and consolidation immunotherapy, the patient achieved a favorable outcome. The patient survived for 31 months, and there were no signs of recurrence or metastasis during follow-up.
ConclusionAt present, there is no clear consensus on the consolidation treatment plan after CCRT for sinonasal NUT cancer. We used consolidation immunotherapy for the first time and achieved good efficacy, providing an innovative and promising treatment plan for refractory sinonasal NUT cancer.

背景：睾丸核蛋白（Nuclear protein in testis, NUT）癌又称中线癌，好发于中线邻近器官，如鼻窦与纵隔。NUT癌极为罕见，预后不佳。
病例报告：本研究报道1例44岁女性鼻窦NUT癌患者，计算机断层扫描（computed tomography）显示其左侧额窦、筛窦及左侧鼻腔存在软组织肿块，肿瘤与左侧内直肌分界不清。经头颈肿瘤领域多学科专家团队会诊评估，该患者无法接受手术治疗，遂推荐行根治性同步放化疗（definitive concurrent chemoradiotherapy, CCRT）。患者接受同步放化疗后，予以白蛋白结合型紫杉醇联合奈达铂完成3周期巩固化疗，后续使用程序性死亡蛋白-1（programmed death-1, PD-1）抑制剂替雷利珠单抗进行16周期巩固免疫治疗。治疗期间出现免疫相关不良反应，表现为2级甲状腺功能减退症。经同步放化疗、巩固化疗及巩固免疫治疗后，患者获得良好疗效，总生存期达31个月，随访期间未观察到复发或转移征象。
结论：目前，鼻窦NUT癌同步放化疗后的巩固治疗方案尚无明确共识。本研究首次应用巩固免疫治疗并取得良好疗效，为难治性鼻窦NUT癌提供了一种创新且具有临床应用前景的治疗策略。