结肠癌辅助化疗后出现第二次原发性恶性瘤的风险
Tomas Buchler1, Monika Ambrozova2,3, Ondrej Majek2,3
1Department of Oncology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Cancer
|October 8, 2025
概括
对结肠癌幸存者的基于牛利的化疗增加了第二次原发性恶性病的风险,特别是结肠直肠癌. 这凸显了为这些患者量身定制的长期护理策略的需要.
科学领域:
- 在瘤学瘤学.
- 癌症的生存率 癌症的生存率
- 临床流行病学临床流行病学
背景情况:
- 辅助化疗改善了II-III期结肠癌 (CC) 的生存率.
- 有关CC治疗后出现第二次和随后的初级恶性瘤 (SPMs) 的风险存在担忧.
- 临床前数据和注册研究表明,化疗和SPM之间存在潜在的联系.
研究的目的:
- 评估结肠癌幸存者中SPM的发生率.
- 根据不同类型的辅助化疗,比较SPM风险.
- 调查含氧沙的饮食方案与SPM风险之间的关联.
主要方法:
- 对18383名II-III期CC患者 (2010-2022) 的回顾性,基于人口的队列研究.
- 患者被分为三个组:没有化疗,单独使用甲/capecitabine,或甲/capecitabine与oxaliplatin一起使用.
- 用国家癌症登记册数据计算的SPM的标准化发病率 (SIR).
主要成果:
- 与其他组 (SIR, 1.1) 相比,接受黄/capecitabine加上oxaliplatin的患者的SPM总体风险更高 (SIR, 1.5).
- 这种高风险在两个阶段都被观察到,并且在结肠直肠SPM中最为明显.
- 在10年后,氧化组的累计SPM发病率为14.6%,而其他组的发病率为11.0%-12.5%;氧化组的第二次CC风险最高 (SIR,2.2).
结论:
- 基于奥克萨利普拉丁的辅助化疗与长期增加SPM风险有关,特别是第二种结直肠癌.
- 这些发现强调了适应风险的生存护理对结肠癌幸存者的重要性.
- 可能需要进一步的研究来完善治疗策略和监测协议.
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