Second malignant neoplasms after a first cancer in childhood: temporal pattern of risk according to type of treatment.
Second malignant neoplasms after a first cancer in childhood: temporal pattern of risk according to type of treatment.
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DOI：
10.1038/sj.bjc.6690300
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发表时间：
1999-04
影响因子：
8.8
通讯作者：
Lemerle, J
中科院分区：
文献类型：
--
作者：
de Vathaire, F;Hawkins, M;Campbell, S;Oberlin, O;Raquin, MA;Schlienger, JY;Shamsaldin, A;Diallo, I;Bell, J;Grimaud, E;Hardiman, C;Lagrange, JL;Daly-Schveitzer, N;Panis, X;Zucker, JM;Sancho-Garnier, H;Eschwège, F;Chavaudra, J;Lemerle, J
先前已报道了儿童期首次癌症后，实体性第二恶性肿瘤（SMN）风险随时间的变化。然而，尚未进行控制放射剂量分布和既往化疗侵袭性的研究，这可能是观察到的风险随时间变化的原因。本研究的目的是研究治疗对儿童期首次癌症后固体SMN发生率的长期模式的影响。我们研究了来自法国和英国8个中心的4400名患者。患者必须在17岁之前和1985年底之前接受首次癌症治疗后存活3年或以上。对于队列中的每个患者，记录完整的临床、化疗和放疗史。对每例接受外放射治疗的患者，估计了151个部位的辐射剂量。在平均随访15年后，113名儿童形成了稳固的SMN，而一般人群的预期发生率为12.3。在1045例单独接受放疗的患者和2064例接受放疗加化疗的患者中观察到相似的分布模式;固体SMN的相对风险（而非超额绝对风险）在首次治疗后随时间降低;超额绝对风险在首次癌症后至少30年内增加。在控制化疗和SMN主要部位的平均放射剂量后，这种模式仍然存在。当排除患有已知易患SMN的第一种癌症类型或相关综合征的患者时，也保持不变。与单纯放疗相比，化疗增加了儿童期首次癌症后固体SMN的风险，但在首次癌症后的时间内，这种风险的变化并没有显着改变。© 1999癌症研究运动
The variation in the risk of solid second malignant neoplasms (SMN) with time since first cancer during childhood has been previously reported. However, no study has been performed that controls for the distribution of radiation dose and the aggressiveness of past chemotherapy, which could be responsible for the observed temporal variation of the risk. The purpose of this study was to investigate the influence of the treatment on the long-term pattern of the incidence of solid SMN after a first cancer in childhood. We studied a cohort of 4400 patients from eight centres in France and the UK. Patients had to be alive 3 years or more after a first cancer treated before the age of 17 years and before the end of 1985. For each patient in the cohort, the complete clinical, chemotherapy and radiotherapy history was recorded. For each patient who had received external radiotherapy, the dose of radiation received by 151 sites of the body were estimated. After a mean follow-up of 15 years, 113 children developed a solid SMN, compared to 12.3 expected from general population rates. A similar distribution pattern was observed among the 1045 patients treated with radiotherapy alone and the 2064 patients treated with radiotherapy plus chemotherapy; the relative risk, but not the excess absolute risk, of solid SMN decreased with time after first treatment; the excess absolute risk increased during a period of at least 30 years after the first cancer. This pattern remained after controlling for chemotherapy and for the average dose of radiation to the major sites of SMN. It also remained when excluding patients with a first cancer type or an associated syndrome known to predispose to SMN. When compared with radiotherapy alone, the addition of chemotherapy increases the risk of solid SMN after a first cancer in childhood, but does not significantly modify the variation of this risk during the time after the first cancer. © 1999 Cancer Research Campaign
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影响因子：
4.5
作者：
MOOLGAVKAR, SH;VENZON, DJ
通讯作者：
VENZON, DJ
影响因子：
3.4
作者：
PIERCE, DA;VAETH, M;PRESTON, DL
通讯作者：
PRESTON, DL
影响因子：
3.8
作者：
FRANCOIS, P;BEURTHERET, C;DEVATHAIRE, F
通讯作者：
DEVATHAIRE, F
DOI：
10.1093/jnci/88.5.270
发表时间：
1996-03-06
期刊：
JOURNAL OF THE NATIONAL CANCER INSTITUTE
影响因子：
--
作者：
Hawkins, MM;Wilson, LMK;Stovall, MA
通讯作者：
Stovall, MA
影响因子：
45.3
作者：
ANDRIEU, JM;IFRAH, N;FLANDRIN, G
通讯作者：
FLANDRIN, G