Segawa Y, Ohnoshi T, Ueoka H, Miyake K, Takigawa N, Kimura I, Hiraki S, Fujii M, Machida K, Moritaka T
Second Department of Internal Medicine, Okayama University Medical School, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1991 Nov;29(11):1432-8.
Development of double cancer was evaluated in 311 small cell lung cancer patients who had received intensive chemotherapy with or without radiotherapy. Of those, 10 patients (3.2%) developed a second malignancy:stomach cancer in four, non-small cell lung cancer in three, acute myelogenous leukemia in two, and liver cancer in one. The cumulative risk for the development of double cancer was 1.0% at 1-year, 17.0% at 3-years, and 100% at 8.1 years. The relative risk for the development of double cancer calculated by person-year method utilizing age and sex adjusted cancer incidence in Japan was 2.96-fold (p less than 0.01). The risk of non-small cell lung cancer (6.65-fold) and acute myelogenous leukemia (54.9-fold) was particularly high. Of 21 patients who survived disease-free for more than 2 years, 8 patients died; four patients (50%) died of second malignancy, two died of infectious disease, and only two patients died from recurrent small cell lung cancer. These results indicate that a cautious follow-up program for the detection of double cancer is indicated in patients surviving small cell lung cancer.
对311例接受过强化化疗（无论是否接受放疗）的小细胞肺癌患者的双原发癌发生情况进行了评估。其中，10例患者（3.2%）发生了第二种恶性肿瘤：4例为胃癌，3例为非小细胞肺癌，2例为急性髓细胞白血病，1例为肝癌。双原发癌发生的累积风险在1年时为1.0%，3年时为17.0%，8.1年时为100%。利用日本年龄和性别调整后的癌症发病率，通过人年法计算出的双原发癌发生的相对风险为2.96倍（p<0.01）。非小细胞肺癌（6.65倍）和急性髓细胞白血病（54.9倍）的风险尤其高。在21例无病生存超过2年的患者中，8例死亡；4例患者（50%）死于第二种恶性肿瘤，2例死于传染病，仅2例患者死于小细胞肺癌复发。这些结果表明，对于小细胞肺癌幸存者，应开展谨慎的双原发癌监测随访计划。
