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儿童和青少年癌症患者的预后:二十一世纪的挑战。

Outcomes for children and adolescents with cancer: challenges for the twenty-first century.

机构信息

Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD 20892, USA.

出版信息

J Clin Oncol. 2010 May 20;28(15):2625-34. doi: 10.1200/JCO.2009.27.0421. Epub 2010 Apr 19.


DOI:10.1200/JCO.2009.27.0421
PMID:20404250
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2881732/
Abstract

PURPOSE: This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions. METHODS: Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause. RESULTS: Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis. CONCLUSION: When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.

摘要

目的:本报告概述了当前儿童癌症统计数据,以分析过去研究发现对结果的影响,并为确定未来研究方向提供必要信息。

方法:儿童癌症的发病率和生存率数据来自监测、流行病学和最终结果 9(SEER 9)登记处,死亡率数据基于美国各州向疾病控制与预防中心报告的死因。

结果:1975 年至 2006 年间,儿童癌症发病率显著上升,急性淋巴细胞白血病的发病率上升最为显著。1975 年至 2006 年间,儿童癌症死亡率下降了 50%以上。白血病和淋巴瘤的死亡率在整个 32 年期间呈显著下降趋势,尽管自 1998 年以来下降速度有所放缓。对于其余的儿童癌症,1975 年至 1996 年期间死亡率呈显著下降趋势,1996 年至 2006 年期间死亡率保持稳定。所有研究的儿童癌症类别都观察到生存率提高,增加的程度和速度因诊断而异。

结论:当以 1975 年儿童特定死亡率为基准时,1975 年至 2006 年期间,由于在此期间发现和应用了更有效的治疗方法,美国避免了约 38000 例儿童恶性癌症死亡。要继续成功降低儿童癌症死亡率,需要建立在对促进特定儿童癌症生长和存活的分子过程的理解的基础上,采用新的治疗模式。

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本文引用的文献

[1]
Improved early event-free survival with imatinib in Philadelphia chromosome-positive acute lymphoblastic leukemia: a children's oncology group study.

J Clin Oncol. 2009-11-1

[2]
JAK mutations in high-risk childhood acute lymphoblastic leukemia.

Proc Natl Acad Sci U S A. 2009-6-9

[3]
Birth weight and childhood leukemia: a meta-analysis and review of the current evidence.

Int J Cancer. 2009-6-1

[4]
Long-term results for children with high-risk neuroblastoma treated on a randomized trial of myeloablative therapy followed by 13-cis-retinoic acid: a children's oncology group study.

J Clin Oncol. 2009-3-1

[5]
Excellent outcome with reduced treatment for infants with disseminated neuroblastoma without MYCN gene amplification.

J Clin Oncol. 2009-3-1

[6]
Deletion of IKZF1 and prognosis in acute lymphoblastic leukemia.

N Engl J Med. 2009-1-29

[7]
Trends in 5- and 10-year survival after diagnosis with childhood hematologic malignancies in the United States, 1990-2004.

J Natl Cancer Inst. 2008-9-17

[8]
Shortened intensified multi-agent chemotherapy and non-cross resistant maintenance therapy for advanced lymphoblastic lymphoma in children and adolescents: report from the Children's Oncology Group.

Br J Haematol. 2008-10

[9]
What determines the outcomes for adolescents and young adults with acute lymphoblastic leukemia treated on cooperative group protocols? A comparison of Children's Cancer Group and Cancer and Leukemia Group B studies.

Blood. 2008-9-1

[10]
Prognostic factors in metastatic rhabdomyosarcomas: results of a pooled analysis from United States and European cooperative groups.

J Clin Oncol. 2008-5-10

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