期刊
CANCER RESEARCH AND TREATMENT
卷 51, 期 3, 页码 982-991出版社
KOREAN CANCER ASSOCIATION
DOI: 10.4143/crt.2018.298
关键词
Nasopharyngeal; Carcinoma; Secondary; Malignancy; Intensity-modulated radiation therapy; Incidence; Risk factors
类别
资金
- Health & Medical Collaborative Innovation Project of Guangzhou City, China [201803040003]
- Special Support Program of Sun Yat-sen University Cancer Center [16zxtzlc06]
- Sun Yat-sen University Clinical Research 5010 Program [2012011]
- Natural Science Foundation of Guang Dong Province [2017A030312003]
- Innovation Team Development Plan of the Ministry of Education [IRT_17R110]
- Overseas Expertise Introduction Project for Discipline Innovation (111 Project) [B14035]
Purpose The incidence, risk factors and survival impact of secondary primary malignancies (SPMs) among survivors of nasopharyngeal carcinoma (NPC) treated with definitive intensity-modulated radiation therapy (IMRT) with or without chemotherapy are poorly characterized. Materials and Methods Consecutive patients (n=6,377) from the big-data intelligence platform at Sun Yat-sen University Cancer Center, China (in a high-incidence area) with newly diagnosed non-metastatic pathologically proven non-keratinizing undifferentiated NPC treated with IMRT +/- chemotherapy between January 2003 and June 2013 were retrospectively analyzed. Cumulative incidence of SPMs was calculated using the Kaplan-Meier method. Cox proportional hazards model was used to identify potential risk factors for SPMs and assess whether SPMs affect overall survival. Results Of the 6,377 patients, 189 (3.0%) suffered SPMs (median follow-up, 62 months). One-, 2-, 3-, 4-, and 5-cumulative risks of SPMs were 0.4%, 0.9%, 1.6%, 2.2%, and 2.6%, respectively. Latency from start of IMRT to SPMs diagnosis was 37 months (range, 6 to 102 months). In patients with SPMs, 14.3% suffered SPMs within 1 year post-IMRT: 1-3 years, 38.1%; 3-5 years, 33.9%; and > 5 years, 13.7%. Lung cancer was the most common SPM (50/6,377, 0.78%). Multivariate analysis demonstrated sex (male, 64% increase), age (>= 50 years, 68% increase), and smoking history (41% increase) were significant risk factors for SPMs, and SPMs were associated with poorer overall survival. Conclusion This large cohort study confirms SPMs a dreadful complication for long-term survivors of NPC treated with IMRT. SPMs negatively impact overall survival in NPC. Close follow-up is recommended for older male survivors with a smoking history.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据