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在患有霍奇金病的年轻女性中,放射治疗和化疗后的乳腺癌.

Lois B Travis1, Deirdre A Hill, Graça M Dores

  • 1Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Md 20892 , USA. TravisL@mail.nih.edu

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概括
此摘要是机器生成的。

对霍奇金病 (HD) 的高剂量放射治疗显著增加了年轻女性的乳腺癌风险,持续数十年. 治疗造成的卵巢损伤可能会降低这种风险,强调需要终身监测.

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科学领域:

  • 在瘤学瘤学.
  • 辐射瘤学 辐射瘤学
  • 癌症流行病学 癌症流行病学

背景情况:

  • 第二种癌症是长期霍奇金病 (HD) 幸存者的首要死亡原因.
  • 乳腺癌风险在年轻时为HD接受治疗的女性中异常高.
  • 关于放射治疗和化疗剂量及其与HD幸存者的乳腺癌风险相关的定量数据有限.

研究的目的:

  • 量化为HD治疗的年轻女性乳腺癌的长期风险.
  • 评估放射治疗剂量对乳房和化疗暴露与随后的乳腺癌风险之间的关联.
  • 评估卵巢暴露对HD幸存者的乳腺癌风险的影响.

主要方法:

  • 在一个由3817名女性组成的队列中进行了匹配的病例对照研究,这些女性是30岁或更年轻时被诊断出患有HD的1年幸存者.
  • 从1965年至1994年收集的数据,从1996年至1998年进行的研究.
  • 根据对乳腺/卵巢的辐射剂量和累积的化剂剂量评估乳腺癌的相对风险 (RR).

主要成果:

  • 射向乳房的辐射剂量为4Gy或以上,乳腺癌风险增加了3.2倍;风险达到8倍,>40Gy (P<.001趋势).
  • 辐射风险增加持续了放射治疗后25年以上 (RR,2.3;P =.03趋势).
  • 单独的化剂降低了风险 (RR,0.6),而联合治疗显示风险增加了1.4倍 (RR,1.4);风险降低了更多的化剂循环 (P =.003). 卵巢剂量≥5 Gy与低风险相关 (RR,0.4).

结论:

  • 激素刺激似乎对辐射诱导的乳腺癌的发展至关重要,这表明卵巢损伤的风险降低.
  • 高辐射相关的乳腺癌风险仍然存在,即使在高剂量和长时间的随访期间.
  • 终身监测和患者/公众意识计划对于管理这种风险至关重要.