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对于分化甲状腺癌的放射性治疗后,第二次主要恶性新生体的年龄特异性风险
Julia J An1, Mark S Choi2, Chen Yang3,4
1Icahn School of Medicine at Mount Sinai, New York, New York.
JAMA otolaryngology-- head & neck surgery
|August 21, 2025
概括
对差异化甲状腺癌 (DTC) 的放射性治疗增加了第二种癌症的风险,具体风险因年龄而异. 年轻患者面临更高的血液癌症风险,而老年患者则面临更高的固体瘤风险.
科学领域:
- 癌症学
- 核医学
- 流行病学
背景情况:
- 放射性 (RAI) 是差异化甲状腺癌 (DTC) 的标准治疗方法.
- RAI治疗与二次原发性恶性瘤的风险增加有关.
- 这些二次癌症的年龄特异性风险尚不清楚.
研究的目的:
- 研究DTCRA治疗后年龄与第二次原发性恶性瘤 (SPMNs) 的风险之间的关联.
- 在RAI治疗后发生的SPMN类型中确定与年龄相关的模式.
主要方法:
- 使用美国癌症登记处 (SEER计划) 1975-2021年数据进行的回顾性队列研究.
- 包括72412名非转移性DTC患者接受RAI治疗,分为15至44岁,45至64岁和65岁以上的年龄组.
- 使用多变量Poisson回归分析固体和血液性SPMN的相对风险 (RRs),调整年龄,性别和潜伏期.
主要成果:
- 年龄较小的成年人 (15 - 44岁) 患有血液癌症的风险增加 (RR 1. 35),特别是骨髓瘤 (RR 4. 22).
- 中年成人 (45-64岁) 患前列腺癌 (RR 1. 61),唾液腺癌 (RR 10. 22) 和淋巴瘤 (RR 2. 81) 的风险较高.
- 老年人 (65岁以上) 患胃癌 (RR 4. 06),食道癌 (RR 11. 42),皮肤癌 (RR 10. 52) 和急性髓性白血病 (RR 3. 26) 的风险增加. 这一组的整体固体瘤风险较高 (RR1.
结论:
- 在DTC的RAI之后,第二次原发性恶性瘤的风险和类型受到患者年龄的显著影响.
- 在中年与老年幸存者中观察到明显的癌症风险增加模式.
- 对于接受RAI治疗的DTC幸存者,建议采用特定年龄的监测策略,以优化长期健康结果.
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