Risk for second malignancies in non-Hodgkin's lymphoma survivors: a meta-analysis
Risk for second malignancies in non-Hodgkin's lymphoma survivors: a meta-analysis
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DOI：
10.1093/annonc/mdq697
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发表时间：
2011-08-01
影响因子：
50.5
通讯作者：
Sacchi, S.
中科院分区：
文献类型：
--
作者：
Pirani, M.;Marcheselli, R.;Sacchi, S.
背景：晚期副作用正在成为非霍奇金淋巴瘤(NHL)幸存者的一个重要问题。我们打算估计继发性恶性肿瘤(SMN)的汇集相对风险(RR)，以评估与部位相关的RR和不同治疗方法的影响。设计：我们进行了Medline和EMBASE的电子搜索，检索研究SMN风险的文章并报告RR措施。在荟萃分析之前，对这些研究的异质性和发表偏倚进行了评估。使用固定效应模型和随机效应模型估计合并RR。结果：共有23项研究符合纳入标准。SMN总体和实体瘤的合并RR分别为1.88和1.32。我们发现几个特定的癌症部位风险过高。单纯放射治疗不会增加SMN的风险，而化疗和联合治疗会增加RR。回归分析显示，所有SMN与全身照射呈显著正相关，与年龄较小的实体SMN呈显著正相关。结论：我们的研究结果表明，非霍奇金淋巴瘤患者罹患SMN的风险高于普通人群，不同的治疗方法对RR有不同的影响。将需要更多信息来评估与遗传易感性和环境暴露的可能相互作用。
Background: Late side-effects are becoming an important issue in non-Hodgkin's lymphoma (NHL) survivors. We intended to estimate pooled relative risk (RR) of secondary malignant neoplasms (SMNs), to evaluate site-associated RR and the impact of different treatments.Design: We carried out an electronic search of Medline and EMBASE seeking articles investigating the risk of SMNs and reporting RR measures. The studies were evaluated for heterogeneity before meta-analysis and for publication bias. Pooled RRs were estimated using fixed-and random-effects models.Results: A total of 23 studies met the inclusion criteria. Pooled RRs of SMNs overall and for solid tumors were 1.88 and 1.32, respectively. We found an excess of risk for several specific cancer sites. Radiotherapy alone did not increase the risk for SMNs, while chemotherapy and combined treatments augmented the RR. Regression analyses revealed a positive significant association for all SMNs with total body irradiation, and for solid SMNs with younger age. No publication bias was observed.Conclusions: Our results indicate that NHL patients experience a higher risk for SMNs than the general population and that various treatments have different impact on RR. More information will be necessary to evaluate possible interactions with genetic susceptibility and environmental exposure.