Virtanen A, Pukkala E, Auvinen A
Tampere School of Public Health, FI-33014 University of Tampere, Tampere, Finland.
Br J Cancer. 2007 Jul 2;97(1):115-7. doi: 10.1038/sj.bjc.6603805. Epub 2007 May 22.
We evaluated the risk of angiosarcoma after radiotherapy among all patients with cancers of breast, cervix uteri, corpus uteri, lung, ovary, prostate, or rectum, and lymphoma diagnosed in Finland during 1953-2003, identified from the Finnish Cancer Registry. Only angiosarcomas of the trunk were considered, this being the target of radiotherapy for the first cancer. In the follow-up of 1.8 million person-years at risk, 19 angiosarcomas developed, all after breast and gynaecological cancer. Excess of angiosarcomas over national incidence rates were observed after radiotherapy without chemotherapy (standardised incidence ratio (SIR) 6.0, 95% confidence interval (CI) 2.7-11), after both radiotherapy and chemotherapy (SIR 100, 95% CI 12-360), and after other treatments (SIR 3.6, 95% CI 1.6-7.1). In the regression analysis however, the adjusted rate ratio for radiotherapy was 1.0 (95% CI 0.23-4.4). Although an increased risk of angiosarcoma among cancer patients is evident, especially with breast and gynaecological cancer, the excess does not appear to be strongly related to radiotherapy.
我们评估了1953年至2003年期间在芬兰被诊断出患有乳腺癌、子宫颈癌、子宫体癌、肺癌、卵巢癌、前列腺癌或直肠癌以及淋巴瘤的所有患者接受放射治疗后患血管肉瘤的风险，这些患者信息来自芬兰癌症登记处。仅考虑躯干的血管肉瘤，这是首次患癌放射治疗的靶区。在180万人年的随访中，共发生了19例血管肉瘤，均发生在乳腺癌和妇科癌症之后。在未进行化疗的放射治疗后（标准化发病率比（SIR）6.0，95%置信区间（CI）2.7 - 11）、在放射治疗和化疗之后（SIR 100，95% CI 12 - 360）以及在其他治疗之后（SIR 3.6，95% CI 1.6 - 7.1），均观察到血管肉瘤发病率超过全国发病率。然而，在回归分析中，放射治疗的调整率比为1.0（95% CI 0.23 - 4.4）。虽然癌症患者中血管肉瘤风险增加是明显的，尤其是乳腺癌和妇科癌症患者，但这种超额风险似乎与放射治疗没有强烈关联。
