Abdel-Wahab May, Reis Isildinha M, Wu Jiuhua, Duncan Robert
Department of Radiation Oncology, Miller School of Medicine, University of Miami, 1475 NW 12th Ave (D-31), Miami, FL 33 136, USA.
Urology. 2009 Oct;74(4):866-71. doi: 10.1016/j.urology.2009.02.085. Epub 2009 Jul 22.
To determine the incidence of second primary cancer (SPC) and primary pelvic late SPC/radiation-induced SPC after radical prostatectomy and radiation.
A total of 228 235 prostate cancer patients in the 1973-2002 Surveillance, Epidemiology, and End Results database were studied. The age-adjusted estimates of SPCs was calculated. Competing risk multivariable Cox proportional hazards regression analysis was adjusted for age at diagnosis, race or ethnicity, and radiation and was used to evaluate the effect of treatment on SPC.
The overall incidence of SPC was 8.4%. The most frequent pelvic SPCs were bladder (2303 cases), rectum or rectosigmoid junction (1006 cases). The most frequent nonpelvic SPCs were bronchus and lung (4131 cases), colon (2665 cases), and skin (1769 cases). The absolute risk of developing a second malignancy was 1747 cases per 100 000 in the "Radical surgery and x-ray treatment" group and 1581 in the "radical surgery" group. With regard to late primary pelvic SPC, a higher age-adjusted rate of 374 cases per 100 000 was seen in the radiated group.
Radiation after radical surgery increased late primary pelvic SPC. No increases were seen in secondary pelvic or extrapelvic SPCs.
确定根治性前列腺切除术后及放疗后第二原发性癌症（SPC）和原发性盆腔晚期SPC/放射性SPC的发病率。
研究了1973 - 2002年监测、流行病学和最终结果数据库中的228235例前列腺癌患者。计算了SPC的年龄调整估计值。竞争风险多变量Cox比例风险回归分析针对诊断时的年龄、种族或族裔以及放疗进行了调整，并用于评估治疗对SPC的影响。
SPC的总体发病率为8.4%。最常见的盆腔SPC是膀胱癌（2303例）、直肠或直肠乙状结肠交界处癌（1006例）。最常见的非盆腔SPC是支气管和肺癌（4131例）、结肠癌（2665例）和皮肤癌（1769例）。“根治性手术和X线治疗”组中发生第二种恶性肿瘤的绝对风险为每10万人中有1747例，“根治性手术”组为1581例。关于晚期原发性盆腔SPC，放疗组的年龄调整率较高，为每10万人中有374例。
根治性手术后放疗增加了晚期原发性盆腔SPC。继发性盆腔或盆腔外SPC未见增加。
