33例原发食管小细胞癌的临床分析

Clinical Analysis of 33 Cases of Primary Esophageal Small Cell Carcinoma

背景与目的:食管是小细胞癌肺外发病最常见的部位,但其标准的治疗方法目前尚未确立。本研究拟探讨原发食管小细胞癌的临床特征、治疗及预后,尤其是化疗对患者生存的影响。方法:收集1985年1月至2005年12月中山大学肿瘤防治中心收治的33例原发食管小细胞癌的临床资料,回顾性分析其临床特点和治疗方式对患者生存的影响。采用Kaplan-Meier及log-rank法分析临床特征和治疗方法对原发食管小细胞癌预后的影响。结果:全组中位生存时间为11.3个月,1年、3年、5年生存率分别为45.1%、16.6%、3.5%。单因素生存分析显示,临床分期是影响预后的最主要因素。单用局部治疗(手术或放疗)的中位生存时间为6.3个月,1年、2年、3年生存率分别为31.1%、23.5%、8.2%;局部治疗联合化疗的中位生存时间为15.4个月,1年、2年、3年生存率分别为69.3%、34.6%、28.7%。结论:对早期原发食管小细胞癌,手术辅以化疗可改善患者生存。

BACKGROUND ＆ OBJECTIVE. Esophagus is the most commonly involved site of extrapulmonary small cell carcinoma. However, no standard treatment has been established for primary esophageal small cell carcinoma. This study was to summarize the clinical characteristics, treatment, and prognosis of primary esophageal small cell carcinoma, and explore the impact of chemotherapy on the survival. METHODS; The records of 33 patients with primary esophageal small cell carcinoma, treated in Cancer Center of Sun Yat-sen University from Jan. 1985 to Dec. 2005, were reviewed to summarize the clinical characteristics and impact of therapy modality on the survival. Prognostic factors were analyzed by Kaplan-Meier and log-rank method. RESULTS, The median survival time of the 33 patients was 11.3 months; the 1-, 3-, and 5-year survival rates were 45.1%, 16.6%, and 3.5%, respectively. Clinical stage was the most important prognostic factor. The median survival time of the patients received local treatment （surgical operation or radiotherapy） was 6.3 months; the 1-, 2-, 3-year survival rates were 31.1%, 23.5%, and 8.2%, respectively. The median survival time of the patients received local treatment plus chemotherapy was 15.4 months; the 1-, 2-, 3-year survival rates were 69.3%, 34.6%, and 28.7%, respectively. CONCLUSION, Surgical operation plus chemotherapy can improve the survival of the patients with early stage primary esophageal small cell carcinoma.