Curative effect analysis of different clinical characteristics and treatment modalities for primary esophageal small cell carcinoma / 国际肿瘤学杂志

ABSTRACT

Objective To 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.Methods Patients 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 method,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.Results A 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％ C I0.184-0.559,P ＜0.001) and chemotherapy cycles (HR =0.841,95％CI0.737-0.960,P =0.010) were independent prognostic factors for PFS.The Veterans Administration Lung Study Group (VALSG) staging (HR =3.050,95 ％ CI1.606-5.794,P =0.001),radiotherapy or not (HR =0.312,95％CI0.174-0.560,P ＜0.001),and chemotherapy cycle (HR =0.711,95％ CI0.601-0.842,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％.Conclusion VALSG staging is an independent predictor of PESC survival.Comprehensive therapy based on radiotherapy and chemotherapy can improve disease control,reduce metastasis,and improve survival.