第二次原发性乳头甲状腺癌:来自竞争风险分析和RAIT后的见解
Mingjun Wang1, Wenjie Chen1, Peiheng Li1
1Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China.
Clinical endocrinology
|September 8, 2025
概括
第二次原发性乳头甲状腺癌 (2-PTC) 在癌症幸存者中很常见. 术后放射性治疗 (RAIT后) 并没有显著降低中等风险2-PTC患者的死亡率,这表明需要重新评估其使用.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 癌症的生存率 癌症的生存率
背景情况:
- 癌症存活率的上升增加了对第二次原发性恶性瘤 (SPMs) 的关注.
- 乳头甲状腺癌 (PTC) 是一个频繁的SPM,特别是在癌症幸存者.
- 了解第二次初级PTC (2-PTC) 和其治疗是至关重要的.
研究的目的:
- 分析2-PTC患者的临床病理特征和生存率.
- 评估术后放射性治疗 (RAIT后) 对中等风险的2-PTC.的有效性.
- 评估后RAIT对2-PTC患者死亡率的影响.
主要方法:
- 利用SEER-17数据库 (2004-2019) 对6399名2-PTC患者 (第1队列) 和1743名 (第2队列) 的数据库.
- 采用竞争风险回归模型来分析死亡风险.
- 应用了倾向性得分匹配和反向概率治疗权重,以进行可靠的分析.
主要成果:
- 2-PTC患者主要是老年人,女性和白人,以前常见的恶性瘤包括乳腺癌,前列腺癌和皮肤癌.
- 2-PTC的累积死亡率低于之前的原发性恶性瘤或其他原因.
- 在中等风险的2-PTC患者中,RAIT后并没有显著降低死亡率,无论年龄,阶段或先前恶性瘤状况如何.
结论:
- 第二次原发性乳头甲状腺癌通常有良好的预后.
- 术后放射性疗法在中等风险的2-PTC中没有显著的死亡益处.
- 目前对于中等风险的2 - PTC进行后RAIT的使用需要重新评估.
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