以手术为主的综合治疗对食管小细胞癌患者生存期的影响

目的 对我院确诊的17例原发性食管小细胞癌( PESC)的临床特点、治疗方法和预后进行总结,分析以手术为主的综合治疗方法对患者生存期的影响.方法 17例PESC中单纯食管癌根治术2例,单纯放射治疗(放疗)3例,手术+放化疗4例,放疗+化疗7例,单纯化疗1例.化疗采用EP、FP方案,即依托泊苷加顺铂注射液、氟尿嘧啶加顺铂注射液,手术+放化疗者手术后化疗1～2个周期再放疗后再化疗2～3个周期,放疗+化疗者放疗后再化疗3～6个周期.结果 1例广泛期患者单纯化疗后5个月内死亡,5例局限期患者行单纯局部治疗(单纯手术或单纯放疗),1年生存率40.0％(2/5),2年生存率0％.11例局限期患者接受综合治疗(手术+化疗+放疗或化疗+放疗),1年生存率为63.6％( 7/11),2年生存率为54.5％ (6/11),3年生存率为18.1％ (2/11),中位生存期为14个月.综合治疗较单纯治疗生存期有所延长.结论 对PESC患者采用以手术为主的综合治疗方法,有可能延长患者的生存期.

The influence of surgery based multimodality therapy on survival in patients with primary esophageal smallcell carcinoma

Objective To evaluate the influence of different treatment methods on survival in 17 patients with primary esophageal small cell carcinoma by analysis of clinical features, treatment methods and prognosis. Methods Of 17 patients,2 patients accepted radical resection of esophageal cancer,3 patients accepted radiation therapy ,4 patients accepted surgery combined with chemo radiotherapy, 7 patients accepted chemoradiotherapy and 1 patient accepted chemotherapy alone. The chemotherapy regimens included EP （etoposide and cisplatin）and FP （5-fluorouracil and cisplatin）. 1-2 cycles of postoperation chemotherapy followed by radiotherapy and 2-3 cycles of chemotherapy were performed in patients having surgery combined with chemoradiotherapy. Radiotherapy followed by 3-6 cycles of chemotherapy was given to patients having chemoradiotherapy. Results One patient with advanced disease who accepted chemotherapy alone died 5 months later. Five patients with local disease accepted only surgery or radiotherapy,1 year＇s survival rate was 40. 0% （2/5）, 2 years＇survival rate was 0. The other 11 patients with local disease accepted muhimodality therapy, 1 year＇s survival rate was 63.6% （7/11 ） ,2 years＇ survival rate was 54. 5% （6/11 ） ,3 years＇survival rate was 18.1% （2/11 ）, median survival time was 14 months. Conclusions It is possible to extend survival time for patients with primary esophageal small cell carcinoma having surgery based muhimodality theraDv.