Huang J, Mackillop W J
The Radiation Oncology Research Unit, Department of Oncology, Queen's University, Kingston Regional Cancer Center, Kingston, Ontario, Canada.
Cancer. 2001 Jul 1;92(1):172-80. doi: 10.1002/1097-0142(20010701)92:1<172::aid-cncr1306>3.0.co;2-k.
Numerous studies to date have suggested an association between radiation exposure and the development of soft tissue sarcoma. The current study was performed to quantify the risk of soft tissue sarcoma in the vicinity of previously irradiated anatomic regions in women with breast carcinoma.
In this population-based, retrospective cohort study, 194,798 women who were diagnosed with invasive breast carcinoma (exclusive of those with distant metastasis) between 1973--1995 were identified, and subsequent soft tissue sarcoma cases utilizing the data from the Surveillance, Epidemiology, and End Results Program (SEER) were ascertained. Poisson regression analysis was used to calculate age standardized incidence ratios (SIR) and to model the influence of radiotherapy (RT) on the relative risk (RR) between the RT and non-RT cohorts.
A total of 54 women in the RT cohort and 81 women in the non-RT cohort subsequently developed soft tissue sarcoma. In the RT cohort, the SIR was 26.2 (95% confidence interval [95% CI], 16.5--41.4) for angiosarcoma and was 2.5 (95% CI, 1.8--3.5) for other sarcomas; in the non-RT cohort, the SIRs were 2.1 (95% CI, 1.0--4.4) and 1.3 (95% CI, 1.0--1.7), respectively. The RT cohort demonstrated a higher risk of developing both angiosarcoma (RR: 15.9; 95% CI, 6.6--38.1) and other sarcomas (RR: 2.2; 95% CI, 1.4--3.3) compared with the non-RT cohort, and the largest increase was observed in the chest wall/breast. The elevated RR was significant even within 5 years of RT, but it reached a maximum between 5--10 years.
The risk of soft tissue sarcoma, especially angiosarcoma, was elevated after RT in women with breast carcinoma.
迄今为止，众多研究表明辐射暴露与软组织肉瘤的发生之间存在关联。本研究旨在量化乳腺癌女性先前接受过放射治疗的解剖区域附近发生软组织肉瘤的风险。
在这项基于人群的回顾性队列研究中，确定了194798例在1973年至1995年间被诊断为浸润性乳腺癌（不包括有远处转移者）的女性，并利用监测、流行病学和最终结果计划（SEER）的数据确定了随后发生的软组织肉瘤病例。采用泊松回归分析计算年龄标准化发病率比（SIR），并模拟放疗（RT）对放疗队列和非放疗队列之间相对风险（RR）的影响。
放疗队列中有54名女性，非放疗队列中有81名女性随后发生了软组织肉瘤。在放疗队列中，血管肉瘤的SIR为26.2（95%置信区间[95%CI]，16.5 - 41.4），其他肉瘤的SIR为2.5（95%CI，1.8 - 3.5）；在非放疗队列中，SIR分别为2.1（95%CI，1.0 - 4.4）和1.3（95%CI，1.0 - 1.7）。与非放疗队列相比，放疗队列发生血管肉瘤（RR：15.9；95%CI，6.6 - 38.1）和其他肉瘤（RR：2.2；95%CI，1.4 - 3.3）的风险更高，且在胸壁/乳房处观察到最大增幅。即使在放疗后5年内，RR升高也很显著，但在5至10年达到最大值。
乳腺癌女性放疗后软组织肉瘤，尤其是血管肉瘤的风险升高。
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