食管小细胞癌11例的临床特征和综合治疗

Clinical features and multimodality treatment of 11 cases with small-cell esophageal carcinoma

目的:研究食管小细胞未分化癌(SCEC)的临床特点和合理的综合治疗模式。方法:分析本院1990年～1999年间的11例SCEC的临床资料和治疗转归。结果:11例患者中位生存11月,1年生存5例,一年生存率45.45%,3年生存1例。综合治疗9例,中位生存12月,其中包括手术的综合治疗7例,中位生存15月,非手术综合治疗2例,分别生存10月及7月。单一治疗2例,其中手术1例,术后生存5月;化疗1例,生存6月。结论:SCEC预后仍较差,包含化疗的综合治疗目前是比较理想的治疗方式;对于局限期SCEC,外科手术具有不可替代的作用,术前化疗+手术+术后化疗可能是一种较好的综合治疗手段。

Purpose:To investigate the clinical feature of small-cell esophageal carcinoma,and try to find rational combined therapy modality.Methods:A retrospective study was conducted in a total of 11 cases of small cell esophageal carcinoma hospitalized from 1990 to 1999 and the literature of small cell esophageal carcinoma in recent years were re- viewed.Results:The median survival time of these patients is 11 months,five cases survived over 1 year,the 1 yr survival rate is 45.45%;only one patient survived over 3 years;nine cases received multimodality treatment,the median survival time was 12 months,and of which,the median survival time of the seven patients treated with combined regimens including surgical operation was 15 months,and the survival time was 10 months and 7 months respectively in two patients treated with combined regimens not including surgical operation.one patient underwent surgery alone,the survival time was 5 months;one patient received chemotherapy alone and survived 6 months.Conclusions:Small cell esophageal carcinoma has a poor prognosis.multimodality treatment including chemotherapy is an effective approach in improving survival;surgical operation play an important role which can not be replaced and preoperative chemotherapy combined with surgical resection and postoperative chemotherapy may be a better combined treatment modality in local regional small cell carcinoma of e- sophagus.