Long-term population-based risks of second malignant neoplasms after childhood cancer in Britain.
Long-term population-based risks of second malignant neoplasms after childhood cancer in Britain.
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DOI：
10.1038/sj.bjc.6602226
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发表时间：
2004-11-29
影响因子：
8.8
通讯作者：
Stevens, MCG
中科院分区：
文献类型：
--
作者：
Jenkinson, HC;Hawkins, MM;Stiller, CA;Winter, DL;Marsden, HB;Stevens, MCG
在一项以人群为基础的回顾性队列研究中，对16541例截至1987年底在英国接受治疗的儿童癌症3年存活者进行了研究，确定了278例第二恶性肿瘤（SMN），而预期的标准化发病率比（SIR）为6.2。从儿童癌症3年生存期到25年SMN的总体累积风险为4.2%。对非视网膜母细胞瘤儿童期癌症的队列分析显示，随着随访时间的延长，SMN的SIR显著下降。从1980年起，在那些被诊断患有儿童癌症的人中，发生SMN的风险更大，特别是继发性急性髓性白血病。然而，在多变量模型中，这不是一个独立的风险因素。不同治疗组SMN的SIR存在显着异质性（P<0.001），同时接受放疗和化疗的组中观察到的风险最大。观察到的SMN风险与其他基于人群的研究相当。虽然SIR随随访时间的下降以及诊断后几十年内观察到的癌症数量略有增加令人放心，但与最近更强的治疗相关的高风险，特别是白血病的风险令人担忧。
In a population-based, retrospective cohort study of 16 541 3-year survivors of childhood cancer treated in Britain up to the end of 1987, 278 second malignant neoplasms (SMNs) were identified against 39.4 expected giving a standardised incidence ratio (SIR) of 6.2. The overall cumulative risk of an SMN by 25 years from 3-year survival from childhood cancer was 4.2%. Analysis of the cohort of nonretinoblastoma childhood cancers combined revealed a significant decline in SIR of SMN with increasing duration of follow-up. There was a greater risk of developing a SMN, particularly secondary acute myeloid leukaemia, in those diagnosed with childhood cancer from 1980 onwards. However, on multivariate modeling, this was not an independent risk factor. There was significant heterogeneity (P<0.001) in SIR of SMN across different treatment groups, the greatest risk observed in the group exposed to both radiotherapy and chemotherapy. The risks of SMN observed were comparable with those in other population-based studies. While the decline in SIR with duration of follow-up and the small excess numbers of cancers observed over later decades after diagnosis are reassuring, the high excess risk, particularly of leukaemia, associated with recent more intense therapy is of concern.
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影响因子：
8.8
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
通讯作者：
Lemerle, J
影响因子：
168.9
作者：
Kony, SJ;deVathaire, F;BonaitiPellie, C
通讯作者：
BonaitiPellie, C
DOI：
10.1016/s0889-8588(18)30248-x
发表时间：
1993-04-01
影响因子：
2.4
作者：
ROBISON, LL;MERTENS, A
通讯作者：
MERTENS, A
影响因子：
6.4
作者：
BIRCH, JM;MARSDEN, HB
通讯作者：
MARSDEN, HB
影响因子：
--
作者：
HAWKINS, MM;WILSON, LMK;CHESSELLS, JM
通讯作者：
CHESSELLS, JM