Risk of developing second malignant neoplasms in patients with neuroblastoma: a population study of the US SEER database.
Risk of developing second malignant neoplasms in patients with neuroblastoma: a population study of the US SEER database.
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DOI：
10.1186/s13014-021-01943-x
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发表时间：
2021-11-27
期刊：
影响因子：
--
通讯作者：
Liu Z
中科院分区：
文献类型：
--
作者：
Zhen H;Guan H;Ma J;Wang W;Jing S;Miao Z;Zhang F;Liu Z
神经母细胞瘤是儿童常见的颅外恶性肿瘤。其主要治疗方式是化疗、放疗和手术的组合。鉴于化疗方案的进步和骨髓移植在过去几十年中的广泛使用，治疗效果得到了改善，这导致了患者生存期的延长。因此，长期并发症已成为医生和患者日益关注的问题。本研究旨在分析神经母细胞瘤患者的生存率和发生第二恶性肿瘤（SMNs）的危险因素。采用美国国家癌症研究所监测、流行病学和最终结果（SEER）数据库的SEER 18 Regs（1973 - 2015）和SEER 9 Regs（1973-2015）数据进行生存和SMN分析。神经母细胞瘤患者的5年、10年和20年总生存率分别为67%、65%和62%。在38例神经母细胞瘤患者中，以腹部为原发部位者占大多数（63.2%），其次为胸部（26.3%）和其他部位（10.5%）。SMN在非特异性神经母细胞瘤中的发生率（0.87%）高于节细胞神经母细胞瘤（0.3%）。与一般人群相比，SMN的风险显著更高（SIR = 4.36）。消化系统（SIR = 7.29）、骨骼和关节（SIR = 12.91）、泌尿系统（SIR = 23.48）、脑和其他神经系统（SIR = 5.70）和内分泌系统（SIR = 5.84）发生SMN的风险显著较高。多因素分析显示，确诊年份（OR = 2.138，95% CI = 1.634-2.797，p < 0.001）是发生SMN的唯一独立危险因素。本研究确定了神经母细胞瘤患者发生SMN的风险因素，这有助于对高危患者进行个体化筛查，从而实现SMN的早期诊断和治疗。
Neuroblastoma is a common extracranial malignant tumor in children. Its main treatment modality is a combination of chemotherapy, radiotherapy, and surgery. Given the advances in chemotherapy regimens and the widespread use of bone marrow transplantation over the decades, there has been improvement in treatment efficacy, which has led to prolonged patient survival. Accordingly, long-term complications have become a growing concern among physicians and patients. This study aimed to analyze the survival rate of patients with neuroblastoma and the risk factors for developing second malignant neoplasms (SMNs). The SEER 18 Regs (1973–2015) and SEER 9 Regs (1973–2015) data of the surveillance, epidemiology, and end results (SEER) database of the US National Cancer Institute were adopted for survival and SMN analysis. The 5-, 10-, and 20-year overall survival rates of patients with neuroblastoma were 67%, 65%, and 62%, respectively. Among 38 patients with neuroblastoma who presented with SMNs, those with abdomen as the primary site accounted for the majority (63.2%), followed by those with thorax (26.3%) and other sites (10.5%). SMNs occurred more commonly in non-specific neuroblastoma (incidence: 0.87%) than ganglioneuroblastoma (incidence: 0.3%). Compared with the general population, the risk of SMN is significantly higher (SIR = 4.36). The risk of developing SMNs was significantly higher in the digestive system (SIR = 7.29), bones and joints (SIR = 12.91), urinary system (SIR = 23.48), brain and other nervous systems (SIR = 5.70), and endocrine system (SIR = 5.84). Multivariate analysis revealed that the year of diagnosis (OR = 2.138, 95% CI = 1.634–2.797, p < 0.001) was the only independent risk factor for developing SMNs. This study identifies the risk factor for developing SMNs in patients with neuroblastoma, which could facilitate individualized screening for high-risk patients, to allow early diagnosis and treatment of SMNs.
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