■这项系统评价和荟萃分析旨在检查视网膜母细胞瘤(Rb)患者中第二原发癌(SPCs)的风险,遗传和非遗传.先前的研究报道了这些患者人群中SPC的长期风险,但是缺乏对现有证据的全面综合。
■在PubMed中进行了系统搜索,EMBASE,和Cochrane图书馆从成立到2023年3月12日,辅以人工筛选。确定了合格的研究,并提取数据。主要结果指标是Rb患者SPCs的标准化发生率(SIRs)。使用随机或固定效应模型计算汇总估计值。使用纽卡斯尔-渥太华量表评估纳入研究的质量。
■十项研究,包括九项高质量的研究,包括在这次审查中。遗传性Rb患者中SPCs的SIR的汇总估计为17.55(95%CI=13.10-23.51),而非遗传性Rb患者SPC的SIR的汇总估计值为1.36(95%CI=0.90~2.04).观察到不同SPC类型的SIR存在显着差异(P=0.028),包括鼻腔肿瘤(SIR=591.06,95%CI=162.79-2146.01),骨肿瘤(SIR=442.91,95%CI=191.63-1023.68),软组织肉瘤(SIR=202.93,95%CI=114.10-360.93),中枢神经系统(SIR=12.84,95%CI=8.80-18.74),女性乳腺癌(SIR=3.68,95%CI=2.52-5.37)。在遗传性Rb患者中,化疗和放疗与SPCs风险增加相关。
■本综述的结果表明,遗传性Rb患者发生SPCs的风险显著升高,而非遗传性Rb患者没有表现出相同的风险。此外,在不同SPC类型的SIR中观察到显著差异。治疗技术,特别是化疗和放疗,与遗传性Rb患者SPCs风险增加相关。这些发现强调了对Rb患者进行辐射防护的重要性,以及对这一高危人群进行进一步研究和量身定制的管理策略的必要性。
UNASSIGNED: This systematic review and meta-analysis aimed to examine the risk of second primary cancers (SPCs) among retinoblastoma (Rb) patients, both
hereditary and nonhereditary. Previous studies have reported on the long-term risk of SPCs in these patient populations, but a comprehensive synthesis of the existing evidence is lacking.
UNASSIGNED: A systematic search was conducted in PubMed, EMBASE, and Cochrane Library from inception to 12 March 2023, supplemented by manual screening. Eligible studies were identified, and data were extracted. The primary outcome measure was the standardized incidence ratios (SIRs) of SPCs in Rb patients. Summary estimates were calculated using random or fixed effects models. The quality of included studies was assessed using the Newcastle-Ottawa Scale.
UNASSIGNED: Ten studies, including nine high-quality studies, were included in this review. The summary estimate of SIR for SPCs among
hereditary Rb patients was 17.55 (95% CI=13.10-23.51), while the pooled estimate of SIR for SPCs among nonhereditary Rb patients was 1.36 (95% CI=0.90-2.04). Significant differences in SIRs for different SPC types were observed (P=0.028), including nasal cavity tumor (SIR=591.06, 95% CI=162.79-2146.01), bone tumor (SIR=442.91, 95% CI=191.63-1023.68), soft tissue sarcoma (SIR=202.93, 95% CI=114.10-360.93), CNS (SIR=12.84, 95% CI=8.80-18.74), and female breast cancer (SIR=3.68, 95% CI=2.52-5.37). Chemotherapy and radiation therapy were associated with an increased risk of SPCs among
hereditary Rb patients.
UNASSIGNED: The findings of this review indicate that
hereditary Rb patients have a significantly elevated risk of developing SPCs, whereas nonhereditary Rb patients do not show the same risk. Furthermore, significant differences were observed in the SIRs of different SPC types. Treatment techniques, specifically chemotherapy and radiation therapy, were associated with an increased risk of SPCs among
hereditary Rb patients. These findings highlight the importance of radiation protection for Rb patients and the need for further research and tailored management strategies for this high-risk population.