在直肠癌中进行放射治疗后的二次原发性癌症风险:以人口为基础的队列研究,与倾向性得分匹配
Anne Schlesinger-Raab1, Gabriele Schubert-Fritschle1, Mia Kim2
1Institute of Medical Information Processing, Biometry and Epidemiology (IBE), Faculty of Medicine, Ludwig-Maximilians-University Munich (LMU), Munich, Germany.
Clinical colorectal cancer
|October 14, 2023
概括
在直肠癌患者的放射治疗 (RT) 没有显著增加二次原发性癌症 (SC) 的总体风险. 然而,RT显示出对前列腺癌的保护作用,但男性的膀癌风险更高.
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:
- 放射治疗 (RT) 对直肠癌 (RC) 患者的二次原发性癌症 (SC) 发展的影响尚不清楚,特别是在真骨盆内的癌症.
- 研究这种关联对于优化RC幸存者的治疗策略和患者结果至关重要.
研究的目的:
- 为了确定SC的发病率在RC患者的基于人口的队列治疗或没有RT.
- 分析RC手术治疗后SC的长期风险,通过RT暴露分层.
主要方法:
- 在1998-2019年期间诊断出13,919名RC患者 (M0阶段) 的队列使用癌症注册数据进行了分析.
- 对11,687种初发性恶性瘤进行了竞争性风险分析,按RT/NRT (无辐射疗法) 分层.
- 倾向性得分匹配用于控制混因素,并创建可比的RT和NRT组.
主要成果:
- 在RT (16.5%) 和NRT (17.4%) 组之间,20年后的SC累积发病率相似 (P=0.2298).
- 接受RT的男性患前列腺癌的风险降低 (HR=0.55).
- 在倾向分数匹配的队列中,RT与更高的膀癌风险相关 (10年发病率为1.1%与NRT中的0.6%相比).
结论:
- 对于直肠癌 (RC) 的放射治疗 (RT) 似乎不会增加二次原发性癌症 (SC) 的总体风险.
- 观察到RT对前列腺癌发展的保护作用,但可能增加膀癌的风险需要进一步调查.
- 未来的研究应侧重于性别特异性分析和当代数据,以更好地了解与RC患者RT相关的长期SC风险.
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