Sagman U, Lishner M, Maki E, Shepherd F A, Haddad R, Evans W K, DeBoer G, Payne D, Pringle J F, Yeoh J L
Department of Medicine, Princess Margaret Hospital, Toronto, Ontario, Canada.
J Clin Oncol. 1992 Oct;10(10):1525-33. doi: 10.1200/JCO.1992.10.10.1525.
The records of 800 patients with small-cell carcinoma of the lung (SCLC) treated between 1971 and 1985 at University of Toronto-affiliated hospitals were reviewed for the occurrence and relative risk of second primary malignancies (SPMs). Almost all patients who developed a SPM were treated previously with chemotherapy and radiation therapy.
Nineteen metachronous SPMs (MSPMs) and 11 synchronous SPMs (SSPMs) were identified. SSPMs were detected between 1 and 12 months after the diagnosis of SCLC. The MSPMs were identified between 1 and 10 years after the diagnosis of SCLC. MSPMs included non-small-cell lung cancer (NSCLC) (four patients), hematologic malignancies (HM) (three patients), and 12 with other solid tumors (OST). The median survival times after the diagnosis of MSPM was 33 months, 10 months, and 1 month, respectively, for those with NSCLC, OST, and HM. Expected cancer incidence rates were used to compute a relative risk rate for developing a MSPM in a subset of 392 patients on whom accurate follow-up information was available. The calculated relative risk for all tumors was 3.73. The relative risk for the development of secondary NSCLC was 6.83.
We suggest that increased predisposition to SPM may relate to secondary effects of multimodality treatment and biologic considerations.
回顾了1971年至1985年间在多伦多大学附属医院接受治疗的800例小细胞肺癌（SCLC）患者的记录，以了解第二原发性恶性肿瘤（SPM）的发生情况和相对风险。几乎所有发生SPM的患者之前都接受过化疗和放疗。
共识别出19例异时性第二原发性恶性肿瘤（MSPM）和11例同时性第二原发性恶性肿瘤（SSPM）。SSPM在SCLC诊断后的1至12个月内被检测到。MSPM在SCLC诊断后的1至10年内被识别出来。MSPM包括非小细胞肺癌（NSCLC）（4例）、血液系统恶性肿瘤（HM）（3例）和12例其他实体瘤（OST）。对于NSCLC、OST和HM患者，MSPM诊断后的中位生存时间分别为33个月、10个月和1个月。利用预期癌症发病率计算了392例有准确随访信息的患者亚组中发生MSPM的相对风险率。计算出的所有肿瘤的相对风险为3.73。继发性NSCLC发生的相对风险为6.83。
我们认为，对SPM易感性增加可能与多模式治疗的继发效应和生物学因素有关。
