Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma
Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma
复制标题
在有限期小细胞食管癌的治疗中，放疗和化疗比手术和化疗的疗效改善相关
DOI：
10.1016/j.radonc.2013.01.008
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发表时间：
2013-03-01
影响因子：
5.7
通讯作者：
Ping, Wang
中科院分区：
文献类型：
--
作者：
Meng, Mao-Bin;Zaorsky, Nicholas G.;Ping, Wang
背景资料：本回顾性研究评价了手术+化疗（S + CT）与放疗+CT（RT + CT）在局限期小细胞食管癌（LS-SCEC. Patients and Methods）患者中的疗效和安全性：纳入分析的患者（来自我院和文献）在1989年至2012年期间接受S + CT或RT + CT治疗。主要终点是总生存期（OS）;次要终点包括肿瘤反应和毒性。Kaplan-Meier OS曲线采用对数秩检验进行比较。结果：共纳入127例患者，其中14例来自我院，113例来自文献。分别有54例（43%）和73例（57%）患者接受了S + CT或RT + CT。所有患者的中位OS为21.0个月。接受RT + CT而非S + CT的患者的OS较长（33.0 vs. 17.5个月，p = 0.02），尤其是N1疾病患者。单因素和多因素分析显示，肿瘤部位（食管上1/3）和治疗方式（S + CT）是影响OS的不良预后因素。结论：与S + RT相比，RT + CT治疗LS-SCEC患者的OS有所改善，因此，RT + CT应作为此类患者的首选治疗方式。(C)2013爱思唯尔爱尔兰有限公司版权所有。
Background: This retrospective study evaluates the efficacy and safety of surgery and chemotherapy (S + CT) vs. radiotherapy and CT (RT + CT) in patients with limited stage small cell esophageal cancer (LS-SCEC).Patients and methods: Patients included in analysis (from our hospital and the literature) were treated with S + CT or RT + CT between 1989 and 2012. The primary end point was overall survival (OS); secondary end points included tumor response and toxicity. Kaplan-Meier OS curves were compared with the log-rank test. Cox regression analysis was used to determine prognosticators for OS.Results: A total of 127 patients were included: 14 from our hospital and 113 from the literature. Fifty-four (43%) and 73 (57%) patients received S + CT or RT + CT, respectively. The median OS of all patients was 21.0 months. OS was longer for those who received RT + CT rather than S + CT (33.0 vs. 17.5 months, p = 0.02), especially those with N1 disease. Uni- and multi-variate analyses showed tumor location (upper 1/3rd of esophagus) and type of treatment (S + CT) were poor prognostic factors of OS.Conclusion: LS-SCEC patients treated with RT + CT had an improved OS compared to those treated with S + RT. Thus, RT + CT should be considered as a primary approach for these patients. (C) 2013 Elsevier Ireland Ltd. All rights reserved.