切除肺癌患者的放射性随访:我们应该减少辐射暴露吗?
F W J Heijboer1, T A Mulders2, M van Straten2
1Department of Respiratory Medicine, Erasmus MC Cancer Institute, University Medical Centre, Rotterdam, The Netherlands.
Lung cancer (Amsterdam, Netherlands)
|November 18, 2024
概括
切除肺癌的年轻患者有较低的复发风险. 目前的后续指导方针可能会导致显著的辐射暴露和癌症风险增加,因此需要个性化策略.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是一门学科.
- 公共卫生 公共卫生
背景情况:
- 肺癌的复发率在切除后很低 (~10%).
- 由于晚期复发风险,长期放射性随访是标准的.
- 随访期间的辐射暴露带来癌症风险,特别是在年轻患者身上.
研究的目的:
- 根据指南 (ENETS,ESMO,CommNETs-NANETS) 评估放射性随访频率和方式.
- 为了估计随访后的累积辐射暴露和终身癌症风险.
- 评估跟踪对切除肺癌的年轻患者的影响.
主要方法:
- 对后续指南 (ENETS,ESMO,CommNETs-NANETS) 的分析.
- 使用年龄和性别因素估计辐射剂量和癌症风险.
- 利用了来自荷兰癌症登记处 (2003-2012) 对切除的肺癌细胞的数据.
主要成果:
- 在706名患者中,32名 (4.5%) 是18-30岁;没有人在中位数127个月后复发.
- 40岁后的随访可能会导致35-308mSv的额外辐射暴露.
- 估计的额外癌症死亡风险在0.2%至3.1%之间,具体取决于指南和性别.
结论:
- 应考虑对具有低复发风险的年轻患者进行个性化,不那么密集的随访.
- 减少辐射暴露对于减轻癌症诱导风险至关重要.
- 需要预测性生物标志物来个性化肺癌类的随访策略.
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