PDF(Pubmed)
Abstract：
OBJECTIVE: Radiation therapy (RT) may increase the risk of second cancer. This study aimed to determine the association between exposure to radiotherapy for the treatment of thoracic cancer (TC) and subsequent secondary lung cancer (SLC).
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for TC. Univariate Cox regression analyses and multiple primary standardized incidence ratios (SIRs) were used to assess the risk of SLC. Subgroup analyses of patients stratified by latency time since TC diagnosis, age at TC diagnosis, and calendar year of TC diagnosis stage were also performed. Overall survival and SLC-related death were compared among the RT and no radiation therapy (NRT) groups by using Kaplan-Meier analysis and competitive risk analysis.
RESULTS: In a total of 329 129 observations, 147 847 of whom had been treated with RT. And 6799 patients developed SLC. Receiving radiotherapy was related to a higher risk of developing SLC for TC patients (adjusted HR, 1.25; 95% CI, 1.19-1.32; P < 0.001). The cumulative incidence of developing SLC in TC patients with RT (3.8%) was higher than the cumulative incidence (2.9%) in TC patients with NRT(P). The incidence risk of SLC in TC patients who received radiotherapy was significantly higher than the US general population (SIR, 1.19; 95% CI, 1.14-1.23; P < 0.050).
CONCLUSIONS: Radiotherapy for TC was associated with higher risks of developing SLC compared with patients unexposed to radiotherapy.
METHODS: The Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for TC. Univariate Cox regression analyses and multiple primary standardized incidence ratios (SIRs) were used to assess the risk of SLC. Subgroup analyses of patients stratified by latency time since TC diagnosis, age at TC diagnosis, and calendar year of TC diagnosis stage were also performed. Overall survival and SLC-related death were compared among the RT and no radiation therapy (NRT) groups by using Kaplan-Meier analysis and competitive risk analysis.
RESULTS: In a total of 329 129 observations, 147 847 of whom had been treated with RT. And 6799 patients developed SLC. Receiving radiotherapy was related to a higher risk of developing SLC for TC patients (adjusted HR, 1.25; 95% CI, 1.19-1.32; P < 0.001). The cumulative incidence of developing SLC in TC patients with RT (3.8%) was higher than the cumulative incidence (2.9%) in TC patients with NRT(P). The incidence risk of SLC in TC patients who received radiotherapy was significantly higher than the US general population (SIR, 1.19; 95% CI, 1.14-1.23; P < 0.050).
CONCLUSIONS: Radiotherapy for TC was associated with higher risks of developing SLC compared with patients unexposed to radiotherapy.
摘要：
目的：放射治疗（RT）可能会增加第二次癌症的风险。这项研究旨在确定放疗治疗胸癌（TC）与随后的继发性肺癌（SLC）之间的关系。
方法：监测，流行病学,和最终结果(SEER)数据库(从1975年到2015年)被查询为TC。单变量Cox回归分析和多个主要标准化发生率（SIR）用于评估SLC的风险。根据自TC诊断以来的潜伏期时间对患者进行亚组分析，TC诊断的年龄，还进行了TC诊断阶段的日历年。通过使用Kaplan-Meier分析和竞争风险分析，比较了RT和无放射治疗（NRT）组的总生存期和SLC相关死亡。
结果：在总共329129个观察中，147847人接受了RT治疗。6799名患者出现SLC。接受放疗与TC患者发展SLC的风险更高(调整后的HR，1.25；95%CI，1.19-1.32；P<0.001）。合并RT的TC患者发生SLC的累积发生率（3.8％）高于合并NRT的TC患者的累积发生率（2.9％）（P）。接受放疗的TC患者发生SLC的风险明显高于美国普通人群(SIR,1.19；95%CI，1.14-1.23；P<0.050）。
结论：与未接受放疗的患者相比，TC的放疗与发生SLC的风险更高相关。
方法：监测，流行病学,和最终结果(SEER)数据库(从1975年到2015年)被查询为TC。单变量Cox回归分析和多个主要标准化发生率（SIR）用于评估SLC的风险。根据自TC诊断以来的潜伏期时间对患者进行亚组分析，TC诊断的年龄，还进行了TC诊断阶段的日历年。通过使用Kaplan-Meier分析和竞争风险分析，比较了RT和无放射治疗（NRT）组的总生存期和SLC相关死亡。
结果：在总共329129个观察中，147847人接受了RT治疗。6799名患者出现SLC。接受放疗与TC患者发展SLC的风险更高(调整后的HR，1.25；95%CI，1.19-1.32；P<0.001）。合并RT的TC患者发生SLC的累积发生率（3.8％）高于合并NRT的TC患者的累积发生率（2.9％）（P）。接受放疗的TC患者发生SLC的风险明显高于美国普通人群(SIR,1.19；95%CI，1.14-1.23；P<0.050）。
结论：与未接受放疗的患者相比，TC的放疗与发生SLC的风险更高相关。
