PDF(Pubmed)
Abstract：
UNASSIGNED: Impact of radiotherapy (RT) for esophageal cancer (EC) patients on the development of secondary head and neck cancer (SHNC) remains equivocal. The objective of this study was to investigate the link between definitive RT used for EC treatment and subsequent SHNC.
UNASSIGNED: This study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database to collect the data of primary EC patients. Fine-Gray competing risk regression and standardized incidence ratio (SIR) and propensity score matching (PSM) method were used to match SHNC patients with only primary head and neck cancer (HNC) patients. Overall survival (OS) rates were applied by Kaplan-Meier analysis.
UNASSIGNED: In total, 14,158 EC patients from the SEER database were included, of which 9,239 patients (65.3%) received RT and 4,919 patients (34.7%) received no radiation therapy (NRT). After a 12-month latency period, 110 patients (1.2%) in the RT group and 36 patients (0.7%) in the NRT group experienced the development of SHNC. In individuals with primary EC, there was an increased incidence of SHNC compared to the general US population (SIR = 5.95, 95% confidence interval (CI): 5.15 - 6.84). Specifically, the SIR for SHNC was 8.04 (95% CI: 6.78 - 9.47) in the RT group and 3.51 (95% CI: 2.64 - 4.58) in the NRT group. Patients who developed SHNC after RT exhibited significantly lower OS compared to those after NRT. Following PSM, the OS of patients who developed SHNC after RT remained significantly lower than that of matched patients with only primary HNC.
UNASSIGNED: An association was discovered between RT for EC and increased long-term risk of SHNC. This work enables radiation oncologists to implement mitigation strategies to reduce the long-term risk of SHNC in patients who have received RT following primary EC.
UNASSIGNED: This study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database to collect the data of primary EC patients. Fine-Gray competing risk regression and standardized incidence ratio (SIR) and propensity score matching (PSM) method were used to match SHNC patients with only primary head and neck cancer (HNC) patients. Overall survival (OS) rates were applied by Kaplan-Meier analysis.
UNASSIGNED: In total, 14,158 EC patients from the SEER database were included, of which 9,239 patients (65.3%) received RT and 4,919 patients (34.7%) received no radiation therapy (NRT). After a 12-month latency period, 110 patients (1.2%) in the RT group and 36 patients (0.7%) in the NRT group experienced the development of SHNC. In individuals with primary EC, there was an increased incidence of SHNC compared to the general US population (SIR = 5.95, 95% confidence interval (CI): 5.15 - 6.84). Specifically, the SIR for SHNC was 8.04 (95% CI: 6.78 - 9.47) in the RT group and 3.51 (95% CI: 2.64 - 4.58) in the NRT group. Patients who developed SHNC after RT exhibited significantly lower OS compared to those after NRT. Following PSM, the OS of patients who developed SHNC after RT remained significantly lower than that of matched patients with only primary HNC.
UNASSIGNED: An association was discovered between RT for EC and increased long-term risk of SHNC. This work enables radiation oncologists to implement mitigation strategies to reduce the long-term risk of SHNC in patients who have received RT following primary EC.
摘要：
■食管癌（EC）患者的放疗（RT）对继发性头颈癌（SHNC）发展的影响仍然模棱两可。这项研究的目的是研究用于EC治疗的最终RT与随后的SHNC之间的联系。
■这项研究是使用监测，流行病学,和最终结果（SEER）数据库收集原发性EC患者的数据。使用精细灰色竞争风险回归和标准化发生率（SIR）和倾向评分匹配（PSM）方法将SHNC患者与仅原发性头颈癌（HNC）患者进行匹配。通过Kaplan-Meier分析应用总生存率(OS)。
■总共，包括SEER数据库中的14158例EC患者，其中9,239例(65.3%)患者接受RT,4,919例(34.7%)患者未接受放疗(NRT).经过12个月的潜伏期，RT组中110例患者（1.2％）和NRT组中36例患者（0.7％）经历了SHNC的发展。在患有原发性EC的个体中，与美国普通人群相比,SHNC的发病率增加(SIR=5.95,95%置信区间(CI):5.15~6.84).具体来说,在RT组中,SHNC的SIR为8.04(95%CI:6.78-9.47),在NRT组中为3.51(95%CI:2.64-4.58)。与NRT后相比，RT后发生SHNC的患者表现出明显较低的OS。在PSM之后,RT后发生SHNC的患者的OS仍然显著低于仅发生原发性HNC的匹配患者.
■发现EC的RT与SHNC的长期风险增加之间存在关联。这项工作使放射肿瘤学家能够实施缓解策略，以降低原发性EC后接受RT的患者发生SHNC的长期风险。
■这项研究是使用监测，流行病学,和最终结果（SEER）数据库收集原发性EC患者的数据。使用精细灰色竞争风险回归和标准化发生率（SIR）和倾向评分匹配（PSM）方法将SHNC患者与仅原发性头颈癌（HNC）患者进行匹配。通过Kaplan-Meier分析应用总生存率(OS)。
■总共，包括SEER数据库中的14158例EC患者，其中9,239例(65.3%)患者接受RT,4,919例(34.7%)患者未接受放疗(NRT).经过12个月的潜伏期，RT组中110例患者（1.2％）和NRT组中36例患者（0.7％）经历了SHNC的发展。在患有原发性EC的个体中，与美国普通人群相比,SHNC的发病率增加(SIR=5.95,95%置信区间(CI):5.15~6.84).具体来说,在RT组中,SHNC的SIR为8.04(95%CI:6.78-9.47),在NRT组中为3.51(95%CI:2.64-4.58)。与NRT后相比，RT后发生SHNC的患者表现出明显较低的OS。在PSM之后,RT后发生SHNC的患者的OS仍然显著低于仅发生原发性HNC的匹配患者.
■发现EC的RT与SHNC的长期风险增加之间存在关联。这项工作使放射肿瘤学家能够实施缓解策略，以降低原发性EC后接受RT的患者发生SHNC的长期风险。
