国际肿瘤学杂志

国际肿瘤学杂志››2019,Vol. 46››Issue (3): 129-134.doi:10.3760/cma.j.issn.1673-422X.2019.03.001

• 论著 •下一篇

原发性食管小细胞癌不同临床特征及治疗方案的疗效分析

李喆1,3,4邢言珂2李宝生3,4

  1. 1济南大学 betway.com 医学与生命科学学院250022； 2山东省德州市人民医院放射治疗科，德州253000； 3山东大学附属山东省肿瘤医院放疗科，济南250117； 4betway.com ，济南250062
  • 出版日期:2019-03-08发布日期:2019-05-17
  • 通讯作者:李宝生 E-mail:baoshli1963@163.com
  • 基金资助:

    国家自然科学基金（81874224、81530060）；国家重点研发计划（2016YFC0105106）；山东省重点研发计划（2017CXZC1206）

Curative effect analysis of different clinical characteristics and treatment modalities for primary esophageal small cell carcinoma

Li Zhe1,3,4, Xing Yanke2, Li Baosheng3,4

  1. 1School of Medicine and Life Sciences, University of JinanShandong Academy of Medical Sciences, Jinan 250022, China; 2Department of Radiation Therapy, Dezhou People′s Hospital, Dezhou 253000, China; 3Department of Radiation Therapy, Shandong Cancer Hospital Affiliated to Shandong University, Jinan 250117, China; 4Shandong Academy of Medical Sciences, Jinan 250062, China
  • Online:2019-03-08Published:2019-05-17
  • Contact:Li Baosheng E-mail:baoshli1963@163.com
  • Supported by:

    National Natural Science Foundation of China (81874224, 81530060); National Key Research and Development Program of China (2016YFC0105106); Key Research and Development Program of Shandong Province of China (2017CXZC1206)

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摘要：目的分析原发性食管小细胞癌（PESC）患者不同临床特征及治疗方案的疗效，寻找影响预后的因素，为临床治疗决策提供参考。方法回顾性入组2008年1月至2017年5月在山东大学附属山东省肿瘤医院经治的PESC患者，收集其临床特征，并通过随访确定其疾病进展时间和生存状态，随访截至2017年10月。应用SPSS 25.0软件进行数据分析，GraphPad Prism 7.0作图。生存分析采用KaplanMeier法，logrank检验比较各组生存曲线差异。将单因素分析差异有统计学意义的因素纳入Cox多因素生存分析。ROC曲线校验模型敏感性和特异性。结果共有随访完整的83例PESC患者纳入研究，其中男性68例，女性15例。平均年龄61.93岁（41～82岁）。全组患者中位无进展生存期（PFS）为9.1个月（1.0～60.0个月），中位总生存期（OS）为26.1个月（1.8～60.0个月）。Cox多因素生存分析显示，是否接受放疗（HR=0.321，95%CI为0.184～0.559，P＜0.001）、化疗周期（HR=0.841，95%CI为0.737～0.960，P=0.010）是PESC患者PFS的独立预后因素；退伍军人肺癌协会（VALSG）分期（HR=3.050，95%CI为1.606～5.794，P=0.001）、是否接受放疗（HR=0.312，95%CI为0.174～0.560，P＜0.001）、化疗周期（HR=0.711，95%CI为0.601～0.842，P＜0.001）是OS的独立预测因素。ROC曲线显示，PFS预测模型敏感性为78.26%，特异性为73.33%，OS预测模型敏感性为80.00%，特异性为58.49%。结论VALSG分期是PESC患者生存的独立预测因素，以放化疗为基础的综合治疗可以提高疾病控制率、减少转移、改善生存。

关键词:治疗效果,预后,综合疗法,原发性食管小细胞癌

Abstract:ObjectiveTo analyze the efficacy of different clinical characteristics and treatment modalities for patients with primary esophageal small cell carcinoma (PESC), and to find out the prognostic factors, and provide reference for clinical treatment decision. MethodsPatients with PESC who were treated at Shandong Cancer Hospital Affiliated to Shandong University from January 2008 to May 2017 were retrospectively enrolled. The clinical features were collected. Their disease progression time and survival status were determined by followup, and the followup ended in October 2017. Data analysis was performed using SPSS 25.0 software, and GraphPad Prism 7.0 was used for mapping. Survival analysis was performed by KaplanMeier method, and logrank test was used to compare the differences in survival curves of each group. Factors with significant differences in univariate analysis were included in the Cox multivariate survival analysis. ROC curve was used to verify the sensitivity and specificity of the model. ResultsA total of 83 PESC patients with a complete followup were included in the study, including 68 males and 15 females. The average age was 61.93 years old (4182 years old). The median progressionfree survival (PFS) was 9.1 months (1.060.0 months) and the median overall survival (OS) was 26.1 months (1.860.0 months). Cox multivariate survival analysis showed radiotherapy or not (HR=0.321, 95%CI: 0.1840.559, P＜0.001) and chemotherapy cycles (HR=0.841, 95%CI: 0.7370.960，P=0.010) were independent prognostic factors for PFS. The Veterans Administration Lung Study Group (VALSG) staging (HR=3.050, 95%CI: 1.6065.794, P=0.001), radiotherapy or not (HR=0.312, 95%CI: 0.1740.560, P＜0.001), and chemotherapy cycle (HR=0.711, 95%CI: 0.6010.842, P＜0.001) were independent predictors of OS. The ROC curve showed that the sensitivity and specificity of the PFS prediction model were 78.26% and 73.33%, and the sensitivity and the specificity of the OS prediction model were 80.00% and 58.49%. ConclusionVALSG staging is an independent predictor of PESC survival. Comprehensive therapy based on radiotherapy and chemotherapy can improve disease control, reduce metastasis, and improve survival.

Key words:Treatment effectiveness,Prognosis;,Comprehensive treatment,Primary esophageal small cell carcinoma