双重高剂量化疗增加了儿科固体瘤中二次恶性新生体的风险
Hana Lim1, Minji Im2, Eun Seop Seo1
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer research and treatment
|November 24, 2023
概括
儿童癌症幸存者面临着二次恶性瘤 (SMN) 的高风险,特别是在高剂量化疗 (HDCT) 或显著的放射治疗 (RT) 之后. 优化治疗和长期跟踪对这些年轻患者至关重要.
科学领域:
- 儿科瘤学 儿科瘤学
- 癌症流行病学 癌症流行病学
- 临床研究 临床研究
背景情况:
- 二次性恶性瘤 (SMN) 是儿童癌症幸存者长期关注的一个重要问题.
- 了解SMN的发病率和风险因素对于改善患者的治疗结果至关重要.
- 双重高剂量化疗 (HDCT) 和放射治疗 (RT) 是常见的治疗方式,具有潜在的长期副作用.
研究的目的:
- 研究小儿固体瘤中SMN的发生率和风险因素.
- 具体评估双重高剂量化疗 (HDCT) 对SMN发展的影响.
- 确定与SMN风险增加相关的患者和治疗特征.
主要方法:
- 在1994年至2014年期间,对1,435名儿科患者 (<19岁) 进行了回顾性分析,这些患者被诊断患有或接受了固体瘤治疗.
- 使用竞争风险方法估计的SMN累积发病率,死亡作为竞争风险.
- 采用多变量分析来识别SMN发展的重大风险因素.
主要成果:
- 10年和20年的SMN累积发病率分别为2.68%和10.19%.
- 显著的SMN风险因素包括放射治疗 (RT) > 2,340 cGy和高剂量化学疗法 (HDCT).
- 常见的SMN包括瘤,瘤和血液恶性瘤,其类型因原发性瘤而异.
结论:
- 在小儿固体瘤患者中,SMN的累积发病率特别高.
- 超过2,340 cGy的双重HDCT和RT剂量是SMN的重要风险因素.
- 治疗强度应该是个性化的,对于儿童癌症幸存者来说,长期随访是必不可少的.
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