Radiotherapy for oral cancer as a risk factor for second primary cancers
Radiotherapy for oral cancer as a risk factor for second primary cancers
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DOI：
10.1016/j.canlet.2004.10.023
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发表时间：
2005-04-08
期刊：
影响因子：
9.7
通讯作者：
Zhang, ZF
中科院分区：
文献类型：
--
作者：
Hashibe, M;Ritz, B;Zhang, ZF
辐射暴露，已知会导致DNA损伤，可能是上呼吸消化道现场癌变的潜在来源。头颈部癌症的放射治疗被认为是第二原发癌的一个可能的危险因素，但结果是模棱两可的。我们使用1973-1999年监测、流行病学和最终结果（SEER）计划的数据评估了口腔癌治疗放射对第二原发癌风险的影响。在30，221例第一原发性口腔鳞状细胞癌患者中，6163例（20.4%）患者发生了第二原发癌，其中5042例为异时性。仅接受放射治疗的患者（RR = 1.64，95% CI = 1.18-2.29）或放疗伴手术（RR = 1.49，95% CI = 1.07，2.06）发生第二原发肿瘤的风险增加，而仅接受手术治疗的患者似乎没有增加风险。（RR = 1.28，95%CI = 0.93，1.76）。与辐射暴露和肿瘤发生之间的预期潜伏期一致，在对口腔实体癌进行10年随访后，辐射成为一个风险因素（RR=2.8，95% CI=1.5，5.2），咽部（RR=5.9，95% CI=1.7，20.7），食管（RR=3.9，95% CI=1.1，13.4）和肺（RR = 1.5，95%CI = 1.0，2.4），第二原发性白血病随访1-5年后（RR = 2.5，95%CI = 1.0，6.7）。口腔癌的放射治疗似乎是第二原发肿瘤的危险因素。进一步的研究，占化疗和检查频率和持续时间的放射治疗将在确认观察到的关联感兴趣。(c)2004爱思唯尔爱尔兰有限公司保留所有权利。
Radiation exposure, known to cause DNA damage, may be a potential source of field cancerization of the upper aerodigestive tract. Radiotherapy for head and neck cancers has been examined as a possible risk factor for second primary cancers, but the results have been equivocal. We evaluated the impact of therapeutic radiation for oral cancer on the risk of second primary cancers with data from the Surveillance, Epidemiology, and End Results (SEER) program for 1973-1999. Among 30,221 first primary oral squamous cell carcinoma patients, 6163 (20.4%) patients developed a second primary cancer, 5042 of which were metachronous. Patients treated with radiation only (RR = 1.64, 95% CI = 1.18-2.29) or radiation with surgery (RR = 1.49, 95% CI = 1.07, 2.06) had elevated risks of developing a second primary tumor, whereas patients treated with surgery only did not appear to be at increased risk (RR = 1.28, 95% CI = 0.93, 1.76). Consistent with an expected latent period between radiation exposure and tumor occurrence, radiation became a risk factor after 10 years of follow-up for solid cancers of the oral cavity (RR=2.8, 95% CI=1.5, 5.2), pharynx (RR=5.9, 95% CI=1.7, 20.7), esophagus (RR=3.9, 95% CI=1.1, 13.4) and lung (RR = 1.5, 95% CI = 1.0, 2.4), and after 1-5 years of follow-up for second primary leukemia (RR = 2.5, 95% CI = 1.0, 6.7). Radiotherapy for oral cancer appears to be a risk factor for second primary tumors. Further studies that account for chemotherapy and examine frequency and duration of radiotherapy would be of interest in confirming the observed association. (c) 2004 Elsevier Ireland Ltd. All rights reserved.