Alfayez Mohammad
Faculty of Medicine, Umm Al-Qura University, Makkah 21514, Saudi Arabia.
World J Clin Oncol. 2020 Oct 24;11(10):836-843. doi: 10.5306/wjco.v11.i10.836.
Primary small cell of esophageal carcinoma is an aggressive tumor with no established treatment guidelines. A treatment strategy was adopted based on small cell carcinoma of the lung because of many similar clinicopathological features. Here, we report one of the largest case series in a western population.
To review the practice of treating small cell oesophageal cancer (SCOC) with different treatment modalities treated at our institution between 2001 and 2014.
A total of 28 cases of SCOC have been identified. All cases were identified with a ten-digit code known as the CHI number. Data was collected using a combination of an electronic database, case notes and the chemotherapy electronic prescribing system (chemocare). We collected information on age, gender, performance status, staging of the disease (limited stage extensive stage).
The results showed 17 patients (61%) were diagnosed with limited stage small cell oesophageal cancer (LS-SCOC), while 11 patients (39%) were diagnosed with extensive stage small cell oesophageal cancer (ES-SCOC). The median age at diagnosis of SCOC was 72 years (range 52-86). The median survival for patients with ES-SCOC was 7 mo (95%CI: 1-12) LS-SCOC [median 23 mo (95%CI: 14-40)], < 0.0001. Subgroup analysis of those who received treatment showed the median survival for patients who received palliative chemotherapy was 7 mo (95%CI: 1.5-12), concurrent chemoradiation 45 mo (95%CI: 38-) and sequential chemoradiation 20 mo (95%CI: 17-25), < 0.0001.
Our data strongly support the use of concurrent chemoradiation in the treatment of LS-SCOC in patients who are fit with no significant comorbidity.
原发性食管小细胞癌是一种侵袭性肿瘤，尚无既定的治疗指南。由于许多临床病理特征相似，因此采用了基于肺癌小细胞癌的治疗策略。在此，我们报告西方人群中规模最大的病例系列之一。
回顾2001年至2014年期间在本机构采用不同治疗方式治疗小细胞食管癌（SCOC）的实践。
共识别出28例SCOC病例。所有病例均通过一个称为CHI编号的十位代码进行识别。数据收集采用电子数据库、病例记录和化疗电子处方系统（chemocare）相结合的方式。我们收集了年龄、性别、体能状态、疾病分期（局限期 广泛期）等信息。
结果显示，17例患者（61%）被诊断为局限期小细胞食管癌（LS-SCOC），而11例患者（39%）被诊断为广泛期小细胞食管癌（ES-SCOC）。SCOC诊断时的中位年龄为72岁（范围52 - 86岁）。ES-SCOC患者的中位生存期为7个月（95%CI：1 - 12），LS-SCOC患者为[中位23个月（95%CI：14 - 40）]，P < 0.0001。对接受治疗患者的亚组分析显示，接受姑息化疗患者的中位生存期为7个月（95%CI：1.5 - 12），同步放化疗为45个月（95%CI：38 - ），序贯放化疗为20个月（95%CI：17 - 25），P < 0.0001。
我们的数据有力支持在无明显合并症的合适患者中使用同步放化疗治疗LS-SCOC。
