在接受乳腺癌辐射后,患上随后的初级肺癌的风险
Lye-Yeng Wong1, Ntemena Kapula1, Hao He1
1Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, Calif.
JTCVS open
|January 11, 2024
概括
乳腺癌的放射治疗略有增加后续肺癌的风险,但这种风险低于之前报告的风险. 现代辐射技术可能会改善患者的治疗结果并降低二次癌症风险.
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) 是乳腺癌治疗的基石,特别是在乳腺保护疗法中.
- 了解与RT相关的长期风险,如二次原发性肺癌,对于患者管理至关重要.
研究的目的:
- 研究30年来接受RT治疗的乳腺癌患者随后发生的初级肺癌的发生率.
- 为了量化乳腺癌放射治疗后肺癌风险的演变.
主要方法:
- 利用了非转移性乳腺癌患者的监测,流行病学和最终结果 (SEER) 数据库 (1988-2014).
- 鉴定了患有初级肺癌的患者 乳腺癌诊断后.
- 使用多变量回归分析,按随访间隔分层 (5-9,10-15,>15年).
主要成果:
- 在612,746名患者中,319,014人接受了RT. 随后的肺癌发生在RT组的1.74%,而非RT组的1.68%.
- 在RT组中观察到统计学上显著增加的ipsilateral肺癌风险:HR 1.14 (5-9年),1.28 (10-15年) 和1.30 (>15年).
- 在任何随访间隔中都没有发现 contralateral 肺癌的风险增加.
结论:
- 乳腺癌RT后发展原发性肺癌的风险低于此前估计的.
- 现代RT技术可能有助于降低风险概况.
- 这一更新的风险评估对于乳腺癌幸存者的咨询和监测策略至关重要.
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