BLADDER-TUMORS FOLLOWING CHEMOTHERAPY AND RADIOTHERAPY FOR OVARIAN-CANCER - A CASE-CONTROL STUDY
BLADDER-TUMORS FOLLOWING CHEMOTHERAPY AND RADIOTHERAPY FOR OVARIAN-CANCER - A CASE-CONTROL STUDY
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DOI：
10.1002/ijc.2910630102
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发表时间：
1995-09-27
影响因子：
6.4
通讯作者：
BOFFETTA, P
中科院分区：
文献类型：
--
作者：
KALDOR, JM;DAY, NE;BOFFETTA, P
癌症登记处和医院的一个合作小组对以前接受过卵巢癌治疗的妇女的膀胱肿瘤进行了一项病例对照研究。共确定了63例膀胱肿瘤，并选择了188名对照，年龄，卵巢癌诊断年和生存时间相匹配。对病例和对照组都寻求卵巢癌治疗的全部细节。与仅接受手术治疗的患者相比，仅接受放疗（1.9; 95%置信区间，0.77-4.9）、仅接受化疗（3.2; 0.97-10）和化疗+放疗（5.2; 1.6-16）治疗的患者膀胱肿瘤风险增加。根据是否接受环磷酰胺治疗，将接受化疗的患者分为2组。在接受过放射治疗的患者中，无论是否接受过放射治疗，风险都明显增加（约4倍）。对于仅接受其他药物治疗的患者，与仅接受手术治疗的患者和仅接受放射治疗的患者相比，接受过放射治疗的患者的风险显著增加。根据这些结果，美法仑和塞替派都被认为是潜在的膀胱致癌物。由于环磷酰胺引起的膀胱肿瘤的估计风险是膀胱辐射后风险的两倍多，而且出现得更早。对于这两种药物，在治疗开始后10年以上，风险继续增加。
A collaborative group of cancer registries and hospitals carried out a case-control study of tumours of the bladder in women who had previously been treated for ovarian cancer. A total of 63 cases of bladder tumours were identified, and 188 controls were selected matching for age, year of ovarian cancer diagnosis and survival time. Full details of the treatment for ovarian cancer were sought both for cases and for controls. The risk of bladder tumours was increased for patients who had been treated by radiotherapy alone (1.9; 95% confidence interval, 0.77-4.9), by chemotherapy alone (3.2; 0.97-10), and by chemotherapy and radiotherapy (5.2; 1.6-16), when comparison was made with patients treated only by surgery. Patients treated by chemotherapy were separated into 2 groups according to whether they had received cyclophosphamide. Among those who had, there was a clear increase in risk (approximately 4-fold) regardless of whether or not they had also received radiotherapy, For those who received only other drugs, risk was increased substantially among patients who had also been treated by radiation, as compared with patients treated by surgery alone, and those who had received radiotherapy only. Both melphalan and thiotepa were implicated as potential bladder carcinogens on the basis of these results. The estimated risk of bladder tumours due to cyclophosphamide was more than twice the risk following radiation to the bladder, and it appeared substantially earlier. For-both agents, the risk continued to increase more than 10 years after treatment began.