Kubota S, Kimura M, Inatsuki S, Ohgushi I, Hamamoto K
Department of Radiology, Shikoku Cancer Center.
Nihon Igaku Hoshasen Gakkai Zasshi. 1990 Nov 25;50(11):1396-401.
Radiotherapy is one of the main therapeutic methods for malignant tumors, but on the other hand it can also induce new malignant tumors. Recently, we experienced a case of a 22-year-old woman with triple cancers (Wilms' tumor, thyroid cancer and mucoepidermoid carcinoma of the lung). She had been treated repeatedly for right-sided pulmonary metastases from the Wilms' tumor. The last cancer arose from a different organ in the field irradiated to treat the first cancer, after a latent period of about 20 years. Therefore, this case is classified as highly probable radiation-induced cancer (A-1 group) by the diagnostic criteria for radiation-induced cancer proposed by Sakai et al. Second cancers (radiation-induced cancers) mainly consist of soft tissue sarcomas, leukemias, skin cancers, urinary bladder cancers, large bowel cancers and other tumors. The occurrence of mucoepidermoid carcinoma of the lung as a radiation-induced tumor had not been reported. This patient also showed poor growth of the right breast and marked deformity of the right side of the thorax as late damage from irradiation. We must make efforts to decrease late damage from radiotherapy for pediatric cancers.
放射治疗是恶性肿瘤的主要治疗方法之一,但另一方面它也可能诱发新的恶性肿瘤。最近,我们遇到了一例患有三重癌症(肾母细胞瘤、甲状腺癌和肺黏液表皮样癌)的22岁女性患者。她曾因肾母细胞瘤的右侧肺转移而接受多次治疗。在经过约20年的潜伏期后,最后一种癌症发生在为治疗第一种癌症而照射的区域内的不同器官。因此,根据酒井等人提出的辐射诱发癌症的诊断标准,该病例被归类为高度可能的辐射诱发癌症(A-1组)。第二癌症(辐射诱发癌症)主要包括软组织肉瘤、白血病、皮肤癌、膀胱癌、大肠癌和其他肿瘤。肺黏液表皮样癌作为辐射诱发肿瘤的发生此前尚未见报道。该患者还表现出右乳发育不良以及胸部右侧明显畸形,这是放疗的晚期损伤。我们必须努力减少儿童癌症放疗的晚期损伤。