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小细胞食管癌脑转移患者的临床病理特征及预后:18例患者的回顾性分析

Clinicopathological Features and Prognoses in Patients With Brain Metastases From Small-Cell Esophageal Carcinoma: A Retrospective Analysis of 18 Patients.

作者信息

Jiao Wenpeng, Lin Chi, Xiao Linlin, Zhang Xinyuan, Hu Mengzhu, Zhao Min, Wang Jun

机构信息

Department of Radiation Oncology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China.

Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, NE, United States.

出版信息

Front Oncol. 2021 Apr 16;11:654727. doi: 10.3389/fonc.2021.654727. eCollection 2021.

Abstract

This study aims to examine the clinical characteristics of patients with brain metastases (BM) from small-cell esophageal carcinoma (SCEC) and to explore the association of the corresponding factors with overall survival (OS). The data of 18 patients with brain metastases from SCEC, diagnosed from January 1, 2006, to December 31, 2018, in the Fourth Hospital of Hebei Medical University were analyzed retrospectively. The 18 patients who were included in this study accounted for 6.7% of the patients with SCEC diagnosed from 2006 to 2018. Of the 18 patients, 8 (44.4%) were females. For the entire cohort, the median OS was 7 months, the 1-year OS was 22.2%, and the 2-year OS was 0%. For patients who received whole-brain radiotherapy (WBRT) and for those who did not (13 vs. 5), the median OS was 11.9 and 3 months, respectively, and the 1-year OS was 30.8 and 0%, respectively. When comparing diagnosis-specific Graded Prognostic Assessment (DS-GPA) scores of patients with BM from SCEC ranging from 2.5 to 4 and from 0 to 2, the median OS was 13.1 and 4 months, respectively, and the 1-year OS was 57.1 and 0%, respectively. In the univariable regression, patients who received WBRT had improved OS compared to those who did not (HR = 0.249, = 0.018), and patients with a DS-GPA score of 2.5-4 were associated with improved OS compared with patients with a DS-GPA score of 0-2 (HR = 0.050, = 0.005). The incidence of brain metastases in patients with SCEC is low, but the prognosis in those patients is very poor. The DS-GPA score may be a prognostic factor of patients with BM from SCEC. Brain radiotherapy could improve the survival of these patients.

摘要

本研究旨在探讨小细胞食管癌(SCEC)脑转移患者的临床特征,并探究相关因素与总生存期(OS)的关系。回顾性分析了2006年1月1日至2018年12月31日在河北医科大学第四医院确诊的18例SCEC脑转移患者的数据。本研究纳入的18例患者占2006年至2018年确诊的SCEC患者的6.7%。18例患者中,8例(44.4%)为女性。整个队列的中位OS为7个月,1年OS为22.2%,2年OS为0%。接受全脑放疗(WBRT)的患者和未接受全脑放疗的患者(13例 vs. 5例),中位OS分别为11.9个月和3个月,1年OS分别为30.8%和0%。比较SCEC脑转移患者诊断特异性分级预后评估(DS-GPA)评分在2.5至4分和0至2分的情况时,中位OS分别为13.1个月和4个月,1年OS分别为57.1%和0%。在单变量回归分析中,接受WBRT的患者与未接受WBRT的患者相比,OS有所改善(HR = 0.249,P = 0.018),DS-GPA评分为2.5 - 4分的患者与DS-GPA评分为0 - 2分的患者相比,OS有所改善(HR = 0.050,P = 0.005)。SCEC患者脑转移的发生率较低,但这些患者的预后很差。DS-GPA评分可能是SCEC脑转移患者的一个预后因素。脑部放疗可以提高这些患者的生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f5e9/8085384/53a65f09658f/fonc-11-654727-g0001.jpg

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