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放射治疗后黑色素瘤幸存者的第二次原发性癌症风险:基于人群的队列研究
Ashmitha Ashok Kumar1, Alfred K Lam1, Vinod Gopalan1
1School of Medicine and Dentistry, Griffith University, Gold Coast Campus, Gold Coast 4222, Australia.
Cancer epidemiology
|August 29, 2025
概括
对黑色素瘤幸存者的放射治疗略有增加了第二次原发性癌症 (SPCs) 的风险,特别是放射敏感的癌症. 建议对接受这种治疗的中年男性进行长期风险调整的监测.
科学领域:
- 癌症学
- 辐射瘤学
- 癌症的生存率
背景情况:
- 全球皮肤黑色素瘤的发病率正在上升,生存率的提高需要关注长期健康.
- 第二种原发性癌症 (SPC) 是黑色素瘤幸存者的新兴问题,可能与共同的风险因素或癌症治疗有关.
- 在黑色素瘤幸存者中,放射治疗引起的长期恶性瘤的风险尚不清楚.
研究的目的:
- 在皮肤黑色素瘤幸存者中研究放射治疗与发展第二次原发性癌症 (SPC) 的风险之间的关联.
- 在该人群中确定放射治疗后风险较高的特定癌症类型.
- 为黑色素瘤幸存者提供长期监测策略.
主要方法:
- 在2010年至2024年期间诊断的19640名黑色素瘤患者的回顾性队列研究.
- 包括标准:成年人,原发性皮肤黑色素瘤,治疗后存活时间>=1年,没有先前的恶性瘤.
- 分析包括标准化发病率 (SIR) 和定向非循环图 (DAG) 引导的考克斯回归以估计危险率 (HR) 和过度绝对风险 (EAR).
主要成果:
- 放射治疗与SPC风险增加有关 (HR 1. 13).
- 在第二次原发性黑色素瘤 (HR 3. 45),软组织肉瘤 (HR 2. 87),血液恶性瘤 (HR 1.42) 和肺癌 (HR 1.32) 中观察到较高的风险.
- 这种负担在45-70岁的男性中是最高的,每10,000人/年达到5.1人/年.
结论:
- 放射治疗与黑色素瘤幸存者的长期SPC风险的统计显著增加有关.
- 特定的放射性癌症在放射治疗后具有较高的相对风险.
- 根据风险调整的监测至关重要,特别是对于中年男性,未来的研究应该整合详细的临床和剂量数据.
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