Increased risk of squamous cell esophageal cancer after adjuvant radiation therapy for primary breast cancer
Increased risk of squamous cell esophageal cancer after adjuvant radiation therapy for primary breast cancer
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DOI：
10.1093/aje/kwi050
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发表时间：
2005-02-15
影响因子：
5
通讯作者：
Neugut, AI
中科院分区：
文献类型：
--
作者：
Zablotska, LB;Chak, A;Neugut, AI
先前的研究表明，乳腺癌乳房切除术后的辅助放射治疗增加了10年后第二原发性食管癌的风险，但保乳手术（乳房肿瘤切除术）后的风险尚未确定。作者使用了基于人群的监测、流行病学和最终结果计划的1973-2000年数据，估计相对风险为2.83（95%置信区间：1.35，5.92）和2.17（95%置信区间：1.67，4.02）分别为乳腺切除术后放射治疗后5-9年和大于或等于10年的鳞状细胞食管癌。这种增加主要是由于肿瘤位于食管的上三分之一和中三分之一。乳腺切除术后腺癌或肿瘤切除术后任何类型的食管癌的风险均未发现显著增加。总之，乳房切除术后放射治疗从暴露后5年开始中度增加鳞状细胞食管癌的风险，并持续10年，腺癌的风险没有增加。这一发现似乎是乳腺切除术后放射治疗所使用的射野的功能，其不暴露食管的最低三分之一，腺癌通常发生在那里。
Prior studies have demonstrated that adjuvant radiation therapy following mastectomy for breast cancer increases the risk of second primary esophageal cancer after 10 years, but the risk following breast-conserving surgery (lumpectomy) has yet to be determined. The authors used 1973-2000 data from the population-based Surveillance, Epidemiology, and End Results Program and estimated relative risks of 2.83 (95% confidence interval: 1.35, 5.92) and 2.17 (95% confidence interval: 1.67, 4.02) for squamous cell esophageal cancer at 5-9 and greater than or equal to 10 years, respectively, following postmastectomy radiation therapy. This increase was mainly due to tumors located in the upper and middle thirds of the esophagus. No significant increase in risk was found for adenocarcinoma following mastectomy or for any type of esophageal cancer following lumpectomy. In summary, postmastectomy radiation therapy moderately increases the risk of squamous cell esophageal cancer starting 5 years after exposure, which persists after 10 years, with no increase in the risk of adenocarcinoma. This finding appears to be a function of the portals used for postmastectomy radiation therapy, which do not expose the lowest third of the esophagus, where adenocarcinomas commonly arise.