目的 探討影響原發(fā)性食管小細(xì)胞癌(PSCCE)預(yù)后的因素,以優(yōu)化其治療策略。 方法 回顧性分析2005年6月至2010年2月華西醫(yī)院15例PSCCE患者的臨床資料,其中男13例,女2例;年齡(57.7±2.3)歲;均為胸中段食管癌。檢索ISI和MEDLINE (2001年4月至2010年2月)獲取139例PSCCE患者的臨床資料,其中男94例,女45例;年齡(63.3±10.7)歲;采用Kaplan-Meier法分析性別、年齡、腫瘤部位、病理類型、病變分期和治療方案對(duì)139例患者生存率的影響,生存曲線的比較采用log-rank檢驗(yàn)?!〗Y(jié)果 15例患者中局限期病變(LD)14例,進(jìn)展期病變(ED) 1例;因隨訪尚未完成未納入生存分析。139例患者中LD 88例,2年生存率31.8% (28/88),ED51例,2年生存率7.8%(4/51),兩者差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。放療聯(lián)合化療對(duì)LD和ED患者的生存率均有影響 (P<0.05),而性別、年齡和腫瘤部位等其他因素對(duì)患者生存時(shí)間均無影響(P>0.05)?!〗Y(jié)論 化療是治療PSCCE的基礎(chǔ),在降低PSCCE術(shù)前分期、抑制PSCCE術(shù)后復(fù)發(fā)和轉(zhuǎn)移方面起重要作用。手術(shù)和放療是PSCCE局部治療的有效手段,對(duì)LD宜采用局部治療聯(lián)合化療,而對(duì)ED,放療聯(lián)合化療可作為標(biāo)準(zhǔn)治療方案。
引用本文: 苗振軍,高強(qiáng),林一丹,陳龍奇. 原發(fā)性食管小細(xì)胞癌的臨床病理特點(diǎn)和多學(xué)科治療的療效分析. 中國(guó)胸心血管外科臨床雜志, 2012, 19(4): 390-394. doi: 復(fù)制
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14. | Arquette M, Wasserman T, Govindan R, et al. Phase II evaluation of amifostine as an esophageal mucosal protectant in the treatment of limited-stage small cell lung cancer with chemotherapy and twice-daily radiation. Semin Radiat Oncol, 2002, 12 (1):59-61. |
15. | Yamashita H, Nakagawa K, Asari T, et al. Concurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patients. Diseases of the Esophagus, 2009, 22 (2):113-118. |
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18. | Mitani M, Kuwabara Y, Shinoda N, et al. Long-term survivors after the resection of limited esophageal small cell carcinoma. Diseases of the Esophagus, 2000, 13 (3):259-261. |
19. | 陳耀輝, 張大為, 董國(guó)俊, 等. 原發(fā)性食管小細(xì)胞未分化癌. 中華腫瘤雜志, 1991, 13 (5):366-368.. |
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21. | 周謙君, 楊明訓(xùn), 彭壽行, 等. 原發(fā)性食管小細(xì)胞癌二例. 中國(guó)胸心血管外科臨床雜志, 2001, 8 (3):146.. |
- 1. experience and literature review. Cancer,2000,88 (2):262-267..
- 2. Wong YN, Jack RH, Mak V, et al. The epidemiology and survival of extrapulmonary small cell carcinoma in South East England, 1970-2004. BMC Cancer, 2009, 9:209.
- 3. Brega MP, Conti B, Lequaglie C, et al. The role of surgical therapy for esophageal microcytoma. Experience of there clinical cases and results analysis. Minerva Chir, 2003, 58 (4):629-632.?.
- 4. Thomas WR, Blackstone EH, Valerie WR. A cancer staging primer:Esophagus and esophagogastric junction. J Thorac Cardiovasc Surg, 2010, 139 (3):527-529.
- 5. Hosokawa A, Shimada Y, Matsumura Y, et al. Small cell carcinoma of the esophagus. Analysis of 14 cases and literature review.Hepatogastroenterology, 2005, 52 (66):1738-1741.
- 6. Horai T, Kobayashi A, Tateishi R, et al. A cytologic study of small cell carcinoma of the esophagus. Cancer, 1978, 41 (5):1890-1896.
- 7. 伍佇, 楊俊杰, 張尚福. 原發(fā)性食管小細(xì)胞癌. 中國(guó)胸心血管外科臨床雜志, 2002, 9 (2):96-98..
- 8. Zelen M. Keynote address on biostatistics and data retrieval. Cancer Chemother Rep, 1973, 4 (12):31-42.
- 9. Huncharek M, Muscat J. Small-cell carcinoma of the esophagus-the Massachusetts-General-Hospital experience, 1978 to 1993. Chest, 1995, 107 (1):179-181.
- 10. Medgyesy DC, Wolff RA, Putnam JB Jr, et al.Small cell carcinoma of the esophagus-The University of Texas M. D. Anderson Cancer Center.
- 11. Yun JP, Zhang MF, Hou JH, et al. Primary small cell carcinoma of the esophagus:clinicopathological and immunohistochemical features of 21 cases. BMC Cancer, 2007 (7):38.
- 12. 盧緒菁, 孔穎澤, 王建華. 原發(fā)性食管小細(xì)胞癌的研究進(jìn)展. 世界華人消化雜志, 2009, 17 (34):3519-3523..
- 13. Yau KK, Siu WT, Wong D, et al. Non-operative management of small cell carcinoma of esophagus. Diseases of the Esophagus, 2007, 20 (6):487-490.
- 14. Arquette M, Wasserman T, Govindan R, et al. Phase II evaluation of amifostine as an esophageal mucosal protectant in the treatment of limited-stage small cell lung cancer with chemotherapy and twice-daily radiation. Semin Radiat Oncol, 2002, 12 (1):59-61.
- 15. Yamashita H, Nakagawa K, Asari T, et al. Concurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patients. Diseases of the Esophagus, 2009, 22 (2):113-118.
- 16. Nichols GL, Kelsen DP. Small cell carcinoma of the esophagus. The Memorial Hospital experience 1970 to 1987. Cancer, 1989, 64:1531-1533.
- 17. Hudson E, Powell J, Mukherjee S, et al. Small cell oesophageal carcinoma:an institutional experience and review of the literature. Br J Cancer, 2007, 96 (10):708-711.
- 18. Mitani M, Kuwabara Y, Shinoda N, et al. Long-term survivors after the resection of limited esophageal small cell carcinoma. Diseases of the Esophagus, 2000, 13 (3):259-261.
- 19. 陳耀輝, 張大為, 董國(guó)俊, 等. 原發(fā)性食管小細(xì)胞未分化癌. 中華腫瘤雜志, 1991, 13 (5):366-368..
- 20. Francesc C, Ferran F, Blanca F, et al. Primary small cell carcinoma of the esophagus. A review of the literature with emphasis on therapy and prognosis. Cancer, 1997, 80 (8):1366-1372.
- 21. 周謙君, 楊明訓(xùn), 彭壽行, 等. 原發(fā)性食管小細(xì)胞癌二例. 中國(guó)胸心血管外科臨床雜志, 2001, 8 (3):146..