摘要
目的探讨原发性小细胞食管癌的临床特点和适当治疗方法。方法利用１９８６年１月至１９９３年１２月，我院收治的经病理证实的初治小细胞食管癌６９例，回顾性分析其临床特点和治疗方法。结果①临床特点：本病占我院同期食管癌的１．８％，平均发病年龄６０岁，男女比１．５６∶１，疗前自然病程平均１．９月，胸中下段占９２．８％，溃疡型、蕈伞型所占比例明显高于非小细胞食管癌。②生存分析：全组总的中位生存期为１２．７月，１、３、５年生存率分别为５５％、１８％、１２％。放疗、化疗、手术、放化、术化、放术各组的中位生存期分别为：８、７、１１．５、１６、１６．５、１１月。术化和放化综合组的生存率均明显优于各单一治疗组（均Ｐ＜０．０５）。术前放疗不提高生存期。③死亡原因：各组病例的死亡原因均以远处转移为主，转移部位主要为肝、骨、肺、脑、锁骨上及腹膜后淋巴结。结论原发性小细胞食管癌的治疗应以放化或术化综合治疗为主。
Objective To evalute the clinical characters and treatment of the primary small cell carcinoma of the esophagus.Methods From January 1986 to December 1993 Sixty-nine cases of small cell carcinoma of the esophague proved by pathology were treated in our hospital.The clinical characters and treatment were retrospectively analyzed.Results ①Clinical characters:The incidence of the patients with primary small cell carcinoma of the esophagus was 1.8% of all esophageal cancer.The rate of male and famale was 1.56 ∶1.The mean age of them was 60 years old.In 92.8% of them,the lesions were located at the mid- and lower-esophagus.The mean natural history before treatment was 1.9 months.The ratio of the ulcer style and mushroom-like style was higher than the non-small cell esophageal cancer.②the Survial analysis:The total median survival time was 12.7 monthes.The 1,3,5 years survival rate were 55%,18% and 12% respectively.The median survival time of radiotherapy alone,chemotherapy alone,surgery alone,combined radiotherapy with chemotherapy,combined surgery with chemotherapy,combined preoperative radiotherapy with surgury were 8,7, 11.5 ,16, 16.5 and 11 monthes,respectively.The survival rate of both combined radiotherapy with chemotherapy group and combined surgery with chemotherapy group were significant superior to the single modality therapy group (P< 0.05 ).Preoperative radiotherapy couldn′t improve the survival rate (P> 0.05 ).③The reasons of the death for all of the group were distant metastasis.The metastatic locality mainly was liver,bone,lung,brain,supraclavicular and retroperitoneal lymph nodes.Conclusions Both combined radiotherapy with chemotherapy and combined surgery with chemotherapy was the first choice treatment modality of the primary small cell carcinom of the esophagus.
出处
《中国肿瘤临床与康复》
1999年第3期33-35,共3页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
小细胞食管癌
综合疗法
临床特点
Primary small cell carcinoma of the esophagus Radiotherapy Chemotherapy Surgery Combined modality therapy
