Radiation-related mortality from heart disease and lung cancer more than 20 years after radiotherapy for breast cancer.

Radiation-related mortality from heart disease and lung cancer more than 20 years after radiotherapy for breast cancer.
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DOI:
10.1038/bjc.2012.575
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发表时间:
2013-01-15
影响因子:
8.8
通讯作者:
Darby, S. C.
Darby, S. C.
中科院分区:
医学1区
文献类型:
--
作者:
Henson, K. E.;McGale, P.;Taylor, C.;Darby, S. C.

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乳腺癌放射治疗后可能发生放射相关的心脏病和肺癌,但死亡风险的持续时间尚不确定。根据乳腺癌的偏侧性,使用泊松回归估计了1973-2008年期间在监测、流行病学和最终结果(SEER)癌症登记处记录的558871名乳腺癌女性的死亡率,并随访至2009年1月1日。在1973-1982年期间诊断为乳腺癌并在此后不久接受放射治疗的妇女中,左心室与右心室的心脏死亡率为1.19(1.03-1.38)、1.35(1.05-1.73)、1.64(1.26-2.14)和1.90(1.52-2.37)(2 p趋势:<0.001)。这些女性在<10岁、10-19岁和20岁以上时的同侧与对侧肺癌死亡率分别为1.05(0.57-1.94)、2.04(1.28-3.23)和3.87(2.19-6.82)(趋势2 p:0.002)。在1983- 1992年期间接受辐射的妇女中,有证据表明与辐射有关的肺癌死亡率,但没有心脏病死亡率。对于1993年以来接受辐射的妇女,迄今几乎没有证据表明任何与辐射有关的死亡。在这一人群中,与辐射有关的风险在受照后第三个十年比头二十年更大。
Radiation-related heart disease and lung cancer can occur following radiotherapy for breast cancer but the duration of any mortality risk is uncertain. Mortality ratios, by laterality of breast cancer, were estimated using Poisson regression for 558 871 women recorded with breast cancer during 1973–2008 in the Surveillance, Epidemiology and End Results (SEER) cancer registries and followed until 01 January 2009. For women diagnosed with breast cancer during 1973–1982 and given radiotherapy shortly afterwards, the cardiac mortality ratios, left-sided vs right-sided, were 1.19 (1.03–1.38), 1.35 (1.05–1.73), 1.64 (1.26–2.14) and 1.90 (1.52–2.37) at <10, 10–14, 15–19 and 20+ years since diagnosis (2p for trend: <0.001). The lung cancer mortality ratios, ipsilateral vs contralateral, in these women were 1.05 (0.57–1.94), 2.04 (1.28–3.23) and 3.87 (2.19–6.82) at <10, 10–19 and 20+ years, respectively, (2p for trend: 0.002). For women irradiated during 1983–92 there was evidence of radiation-related mortality for lung cancer, but not for heart disease. For women irradiated since 1993 there is, as yet, little evidence of any radiation-related mortality. In this population, the radiation-related risks were larger in the third decade after exposure than during the first two decades.
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