Department of Radiation Sciences, Oncology, Umeå University, Sweden.
Acta Oncol. 2010 Nov;49(8):1276-82. doi: 10.3109/02841861003782025. Epub 2010 Apr 29.
We analysed the incidence of second primary intracranial tumours in patients with pituitary adenomas treated with radiotherapy compared to the risk of patients not exposed to irradiation and to the general population.
This retrospective cohort study includes 298 patients with pituitary adenomas that received radiotherapy to the pituitary from 1960 to 2007. The patients were recruited from the Cancer Registry of northern Sweden and the local radiotherapy-registry of the University Hospital in Umeå. Only patients with ≥12 months follow-up after diagnosis of pituitary adenoma were included. A cohort of 131 patients with pituitary adenomas not treated with radiotherapy was used as reference. Standard incidence ratios (SIR) between observed and expected number of second primary intracranial tumours were calculated.
The median observation time after diagnosis of pituitary adenoma in 298 patients treated with radiotherapy was 14 years, and the total number of person-years at risk was 4 784. Six (2.0%) of the patients developed second primary intracranial tumours between 7 and 31 years after radiotherapy. Two patients had gliomas and four had meningiomas. The expected number of intracranial tumours was 1.15 giving a SIR of 5.20 (95% CI 1.90-11.31). No significant correlations were found between radiation technique or administered dose and the risk of developing a second primary intracranial tumour. The cumulative risk for second intracranial tumours at 10 and 20 years was 1.3%. Patients not treated with radiotherapy were followed 1 601 years and no second primary intracranial tumour occurred.
The results indicate an increased risk of second primary intracranial tumours in patients treated with radiotherapy for pituitary adenomas, compared to patients not exposed to irradiation and to the general population. Meningiomas were more frequent than gliomas and the median time interval between radiotherapy and second intracranial tumour was 17 years.
分析接受放疗的垂体腺瘤患者与未接受放疗的患者及普通人群相比，第二原发颅内肿瘤的发病率。
这是一项回顾性队列研究，纳入了 298 例 1960 年至 2007 年接受垂体放疗的垂体腺瘤患者。这些患者来自瑞典北部癌症登记处和于默奥大学医院的当地放疗登记处。仅纳入诊断为垂体腺瘤后随访时间≥12 个月的患者。将 131 例未接受放疗的垂体腺瘤患者作为对照组。计算观察到的和预期的第二原发颅内肿瘤数量之间的标准化发病比（SIR）。
298 例接受放疗的患者的中位观察时间为诊断后 14 年，总风险人年数为 4784。6 例（2.0%）患者在放疗后 7 至 31 年内发生第二原发颅内肿瘤。2 例为胶质瘤，4 例为脑膜瘤。预期颅内肿瘤数为 1.15，SIR 为 5.20（95%CI 1.90-11.31）。未发现放射技术或照射剂量与发生第二原发颅内肿瘤的风险之间存在显著相关性。10 年和 20 年的第二颅内肿瘤累积风险分别为 1.3%。未接受放疗的患者随访 1601 年，未发生第二原发颅内肿瘤。
结果表明，与未接受放疗的患者和普通人群相比，接受放疗治疗垂体腺瘤的患者发生第二原发颅内肿瘤的风险增加。脑膜瘤比胶质瘤更常见，放疗与第二颅内肿瘤之间的中位时间间隔为 17 年。
Zotero 插件