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食管小细胞癌:10例分析及已发表数据综述

Small cell carcinoma of the esophagus: analysis of 10 cases and review of the published data.

作者信息

Bennouna J, Bardet E, Deguiral P, Douillard J Y

机构信息

Department of Medical Oncology, Centre René Gauducheau, St. Herblain, France.

出版信息

Am J Clin Oncol. 2000 Oct;23(5):455-9. doi: 10.1097/00000421-200010000-00005.

Abstract

Small cell carcinoma of the esophagus is a rare and aggressive tumor with early widespread dissemination. In this retrospective study, we report epidemiologic, histologic, and clinical characteristics of small cell carcinoma of the esophagus from the analysis of 10 patients, with a literature review. Between 1993 and 1998, 10 patients with small cell carcinoma of the esophagus were treated in our institution, representing 2.8% of all esophageal malignancies diagnosed during this period. Four patients sought treatment for limited disease, whereas six patients had distant metastasis at the time of diagnosis. All patients received polychemotherapy, and a complete response was observed in eight patients. Seven of these patients received subsequent locoregional radiotherapy, with endoesophageal brachytherapy in two patients. The overall median survival was 15.5 months (range, 2-36 months) for all of the patients. In limited stages, the overall median survival was 18.5 months (range, 2-36 months), whereas it was 11 months (range, 6-19 months) for the extensive stage at initial diagnosis. In this article, we report our experience with this uncommon neoplasia and attempt to make comparisons with the cases published in the literature regarding location, symptoms, histopathologic diagnosis, and treatment. We conclude that the optimum treatment seems to be the same as for small cell carcinomas of the lung, that is, a multidrug combination chemotherapy regimen used alone or with sequential radiation.

摘要

食管小细胞癌是一种罕见且侵袭性强的肿瘤,早期即可广泛播散。在这项回顾性研究中,我们通过对10例患者的分析并结合文献复习,报告了食管小细胞癌的流行病学、组织学和临床特征。1993年至1998年间,我们机构共治疗了10例食管小细胞癌患者,占同期诊断的所有食管恶性肿瘤的2.8%。4例患者因疾病局限而寻求治疗,而6例患者在诊断时已有远处转移。所有患者均接受了多药化疗,8例患者观察到完全缓解。其中7例患者随后接受了局部区域放疗,2例患者接受了食管内近距离放疗。所有患者的总体中位生存期为15.5个月(范围2 - 36个月)。在疾病局限期,总体中位生存期为18.5个月(范围2 - 36个月),而初始诊断为广泛期的患者中位生存期为11个月(范围6 - 19个月)。在本文中,我们报告了我们对这种罕见肿瘤的治疗经验,并试图与文献中发表的病例在肿瘤位置、症状、组织病理学诊断和治疗方面进行比较。我们得出结论,最佳治疗方案似乎与肺癌小细胞癌相同,即单独使用或与序贯放疗联合使用的多药联合化疗方案。

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