肺外小細(xì)胞癌主要見于食管,，原發(fā)性小細(xì)胞食管癌在所有食管癌中占了1.0-2.8%。本研究為回顧性研究,，旨在評(píng)價(jià)手術(shù)聯(lián)合化療和放療聯(lián)合化療對(duì)某些分期的小細(xì)胞食管癌（LSSCEC）患者的治療效果和安全性,。來自中國天津醫(yī)科大學(xué)的Mao-Bin Meng等為了解決上述問題而進(jìn)行了相關(guān)研究，他們的研究結(jié)果發(fā)表在Radiother Oncol 3月的在線期刊上,。
納入本研究最后分析的患者包括來自于Mao-Bin Meng所在醫(yī)院和既往文獻(xiàn)中的小細(xì)胞食管癌患者,，這些患者在1989年至2012年期間分別接受化療聯(lián)合放療或手術(shù)聯(lián)合化療,。研究的主要終點(diǎn)事件為患者的總體生存期,，次要終點(diǎn)包括腫瘤對(duì)治療的反應(yīng)和治療所帶來的毒性反應(yīng)。研究者比較了總體生存期的Kaplan-Meier曲線和Log-rank檢驗(yàn),。并采用Cox回歸分析確定總體生存期的預(yù)測因子,。
在本研究中，研究者共納入了127名患者,，其中14名來自研究者所在的醫(yī)院,，另有113患者來自于既往文獻(xiàn)資料,。其中54名（43%）患者接受手術(shù)聯(lián)合化療，另有73名（57%）患者接受放療聯(lián)合化療,。所有患者的中位總體生存期為21.0月,。研究者發(fā)現(xiàn)放療聯(lián)合化療組患者的總體生存期要長于手術(shù)聯(lián)合化療組，分別為33.0月和17.5月,，兩組的差異具有顯著統(tǒng)計(jì)學(xué)意義,，并且研究者觀察到在N1分期的患者中猶是如此。研究者所進(jìn)行的單變量和多變量分析顯示腫瘤的部位（位于食管上1/3）和治療類型（手術(shù)聯(lián)合化療）是患者預(yù)后較差的預(yù)測因素,。
本研究結(jié)果指出,，在N1小細(xì)胞食管癌患者中，與手術(shù)聯(lián)合化療相比,，放療聯(lián)合化療更能改善上述患者的總體生存期,。因此，在這些患者中,，放療聯(lián)合化療應(yīng)成為首選的治療方案,。（生物谷Bioon.com）
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Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma
Meng MB Zaorsky NG Jiang C Tian LJ Wang HH Liu CL Wang J Tao Z Sun Y Wang J Pang QS Zhao LJ Yuan ZY Ping W
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 21.0months. OS was longer for those who received RT+CT rather than S+CT (33.0 vs. 17.5months, 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.
