Panda Goutam Santosh, Noronha Vanita, Yadav Subhash, Joshi Amit, Patil Vijay, Menon Nandini, Kumar Rajiv, Janu Amit, Mahajan Abhishek, Purandare Nilendu, Agarwal Jai Prakash, Karimundackal George, Prabhash Kumar
Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
Ecancermedicalscience. 2022 May 19;16:1393. doi: 10.3332/ecancer.2022.1393. eCollection 2022.
Small cell carcinoma of the oesophagus (SCCE) is a rare and aggressive tumour with no established standard treatment.
This is a retrospective study of adult patients with histologically proven SCCE registered between February 2011 and March 2020 at Tata Memorial Hospital in Mumbai.
There were 56 patients, with 29 (51.8%) having limited-stage disease (LD) and 27 (48.2%) having extensive-stage disease (ED). The median age was 58 (interquartile range = 51-65) years; 57.1% were men; and 40% were smokers. Among LD-SCCE patients, 23 underwent local therapy, i.e., radiation (19, 65.5%) and surgery (4, 13.8%), and 27 received chemotherapy in neoadjuvant (23, 79.3%), concurrent (18, 62.1%) and adjuvant (4, 13.8%) settings. Totally, 19 ED-SCCE patients (70.4%) received chemotherapy. Prophylactic cranial irradiation (PCI) was delivered to 11 (37.9%) and 7 (25.9%) patients with LD-SCCE and ED-SCCE, respectively. Significant grade 3 or more chemotoxicities in patients with LD-SCCE and ED-SCCE included febrile neutropenia in 33.3% and 23.5%, anaemia in 9.5% and 17.6%, and dyselectrolytemia in 14.3% and 11.8%, respectively. The median overall survival (OS) in LD-SCCE and ED-SCCE was 22.9 (95% CI = 1.8-44.1) months and 11.8 (95% CI = 7.3-16.4) months, respectively. Age <60 years ( = 0.004) and tumour epicentre in the lower third oesophagus ( = 0.002) were independent good prognostic factors for OS in LD-SCCE and ED-SCCE patients, respectively. The incidence of brain metastasis was low, at both presentation (1/27, 3.7%) and relapse (5/56, 8.9%).
Although the survival of LD-SCCE is better than ED-SCCE, it is still under 2 years. Brain metastases are uncommon and the role of PCI is uncertain.
食管小细胞癌（SCCE）是一种罕见且侵袭性强的肿瘤，尚无既定的标准治疗方法。
这是一项对2011年2月至2020年3月在孟买塔塔纪念医院登记的经组织学证实的成年SCCE患者的回顾性研究。
共有56例患者，其中29例（51.8%）为局限期疾病（LD），27例（48.2%）为广泛期疾病（ED）。中位年龄为58岁（四分位间距=51 - 65岁）；57.1%为男性；40%为吸烟者。在LD - SCCE患者中，23例接受了局部治疗，即放疗（19例，65.5%）和手术（4例，13.8%），27例在新辅助（23例，79.3%）、同步（18例，62.1%）和辅助（4例，13.8%）治疗阶段接受了化疗。共有19例ED - SCCE患者（70.4%）接受了化疗。分别对11例（37.9%）LD - SCCE患者和7例（25.9%）ED - SCCE患者进行了预防性颅脑照射（PCI）。LD - SCCE和ED - SCCE患者中显著的3级或更高级别的化疗毒性反应分别包括发热性中性粒细胞减少症为33.3%和23.5%、贫血为9.5%和17.6%、电解质紊乱为14.3%和11.8%。LD - SCCE和ED - SCCE患者的中位总生存期（OS）分别为22.9个月（95%CI = 1.8 - 44.1）和11.8个月（95%CI = 7.3 - 16.4）。年龄<60岁（P = 0.004）和肿瘤中心位于食管下三分之一（P = 0.002）分别是LD - SCCE和ED - SCCE患者OS的独立良好预后因素。脑转移的发生率较低，在初诊时（1/27，3.7%）和复发时（5/56，8.9%）均如此。
尽管LD - SCCE的生存期优于ED - SCCE，但仍不足2年。脑转移并不常见，PCI的作用尚不确定。
