Second malignant tumors following treatment during childhood and adolescence for cancer.
Second malignant tumors following treatment during childhood and adolescence for cancer.
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DOI：
10.1002/mpo.2950220102
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发表时间：
1994
期刊：
影响因子：
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通讯作者：
D. M. Green;M. Zevon;P. Reese;G. S. Lowrie;J. Gaeta;J. Pearce;A. Michalek;E. A. Stephens
中科院分区：
文献类型：
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作者：
D. M. Green;M. Zevon;P. Reese;G. S. Lowrie;J. Gaeta;J. Pearce;A. Michalek;E. A. Stephens
许多儿童和青少年癌症患者接受致癌化学治疗剂和放射治疗，以实现其恶性肿瘤的永久控制。这些方式可能会在成功治疗的患者中诱发新的癌症。为了确定疾病和治疗因素，增加发生第二个恶性肿瘤的风险后，现代治疗癌症的儿童或青少年，我们回顾了1,406例未经治疗的患者的过程中，诊断时年龄小于20岁，并在罗斯韦尔公园癌症研究所治疗1960年1月1日至1989年12月31日。18名患者在首次癌症诊断后2.65-25.65年发生了第二次恶性肿瘤，包括两例脑膜瘤。确诊后25年，第二次恶性肿瘤的精算风险为5.6%。使用考克斯比例风险模型，我们确定了既往BCNU（P = 0.0055）和阿霉素（P = 0.0254）治疗是与第二恶性肿瘤风险显著相关的唯一因素。第二个恶性肿瘤的中枢神经系统发生后，治疗与亚硝基脲。必须仔细随访成功治疗的患者，以在早期阶段识别与治疗相关的恶性肿瘤。
Many pediatric and adolescent cancer patients are treated with carcinogenic chemotherapeutic agents and radiation therapy to achieve permanent control of their malignancy. These modalities may induce a new cancer in the successfully treated patient. To identify disease and treatment factors which increased the risk of occurrence of a second malignant tumor following modern treatment for cancer during childhood or adolescence, we reviewed the courses of 1,406 previously untreated patients who were less than 20 years of age at diagnosis and were treated at Roswell Park Cancer Institute between January 1, 1960 and December 31, 1989. Eighteen patients developed a second malignant tumor, including two meningiomas, 2.65-25.65 years after diagnosis of the first cancer. The actuarial risk of a second malignant tumor was 5.6% at 25 years after diagnosis. Using Cox proportional hazards modelling, we identified prior therapy with BCNU (P = 0.0055) and doxorubicin (P = 0.0254) as the only factors that were significantly associated with the risk of a second malignant tumor. Three second malignant tumors of the central nervous system occurred following treatment with a nitrosourea. Successfully treated patients must be carefully followed to identify treatment related malignant tumors at an early stage.