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食管原发性小细胞癌患者的辅助治疗方式:一项多中心临床结局的回顾性队列研究

Adjuvant Therapeutic Modalities in Primary Small Cell Carcinoma of Esophagus Patients: A Retrospective Cohort Study of Multicenter Clinical Outcomes.

作者信息

Zou Bingwen, Li Tao, Zhou Qiang, Ma Daiyuan, Chen Yongshun, Huang Meijuan, Peng Feng, Xu Yong, Zhu Jiang, Ding Zhenyu, Zhou Lin, Wang Jin, Ren Li, Yu Min, Gong Youling, Li Yanying, Chen Longqi, Lu You

机构信息

From the Department of Thoracic Oncology (BZ, MH, FP, YX, JZ, ZD, LZ, JW, LR, MY, YG, Y Li, Y Lu), Cancer Center, West China Hospital/Medical School, Sichuan University; Department of Radiochemotherapy Oncology (TL), Sichuan Provincial Cancer Hospital, Chengdu; Department of Oncology (QZ), Suining Center Hospital, Suining; Department of Radiotherapy Oncology (DM), Affiliated Hospital of North Sichuan Medical College, Nanchong; Department of Radiotherapy Oncology (YC), Henan Provincial Cancer Hospital, Zhengzhou; Department of Thoracic Surgery (LC), West China Hospital/Medical School, Sichuan University, Chengdu, China.

出版信息

Medicine (Baltimore). 2016 Apr;95(17):e3507. doi: 10.1097/MD.0000000000003507.

Abstract

To evaluate the treatment pattern and survival of patients receiving radical resection for primary small cell carcinoma of the esophagus (PSCCE).This retrospective study included 150 patients who received radical resection of PSCCE. Data were retrieved from 4 centers in Western China. Thirty-nine of 150 patients received postoperative chemo-radiotherapy, 62 received postoperative chemotherapy, and 49 received radical resection only. The median radiation dosage was 50 Gy. The chemotherapeutic regimen was platinum-based and lasted for 2 to 6 cycles (median, 3).Median disease-free survival (mDFS) and overall survival (mOS) were 12.0 and 18.3 months, respectively. Subgroup analysis revealed that postoperative therapy did not improve survival in limited stage I (LSI) disease, whereas postoperative chemotherapy improved survival in limited stage II (LSII) disease. Relative to chemotherapy alone, chemoradiotherapy did not improve survival in patients with completely resected LSII disease. A multivariate analysis indicated an association of no postoperative chemotherapy with shorter DFS (P = 0.050) and OS (P = 0.010). Higher lymph node stage and length of disease longer than 3 cm were poor prognostic factors for both DFS and OS.Adjuvant chemotherapy improves survival in PSCCE patients with completely resected LSII disease. Adjuvant treatment with postoperative chemotherapy alone or postoperative chemo-radiotherapy does not increase survival in completely resected LSI disease.

摘要

评估接受原发性食管小细胞癌(PSCCE)根治性切除患者的治疗模式及生存情况。这项回顾性研究纳入了150例行PSCCE根治性切除的患者。数据来自中国西部的4个中心。150例患者中,39例接受了术后放化疗,62例接受了术后化疗,49例仅接受了根治性切除。中位放疗剂量为50 Gy。化疗方案以铂类为基础,持续2至6个周期(中位周期数为3)。中位无病生存期(mDFS)和总生存期(mOS)分别为12.0个月和18.3个月。亚组分析显示,术后治疗并不能改善局限I期(LSI)疾病患者的生存,而术后化疗可改善局限II期(LSII)疾病患者的生存。相对于单纯化疗,放化疗并不能改善LSII期完全切除患者的生存。多因素分析表明,未进行术后化疗与较短的DFS(P = 0.050)和OS(P = 0.010)相关。较高的淋巴结分期和疾病长度超过3 cm是DFS和OS的不良预后因素。辅助化疗可改善LSII期完全切除的PSCCE患者的生存。单纯术后化疗或术后放化疗的辅助治疗并不能提高LSI期完全切除患者的生存。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bf4c/4998720/7a80ba2fdcba/medi-95-e3507-g002.jpg

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