CESP University, Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, Villejuif, France.
Cancer and Radiation Team, Gustave Roussy, Villejuif, France.
Br J Radiol. 2019 Jan;92(1093):20180390. doi: 10.1259/bjr.20180390. Epub 2018 Sep 12.
Improvements in cancer survival have made the long-term risks from treatments more important, in particular among the children, adolescents and young adults who are more at risk particularly due to a longer life expectancy and a higher sensitivity to treatments. Subsequent malignancies in cancer survivors now constitute 15 to 20% of all cancer diagnoses in the cancer registries. Lots of studies are published to determine risk factors, with some controversial findings. Just data from large cohorts with detailed information on individual treatments and verification of what is called "secondary cancers" can add some knowledge, because their main difficulty is that the number of events for most second cancer sites are low, which impact the statistical results. In this review of the literature, we distinguish second and secondary cancers and discuss the factors contributing to this increased risk of secondary cancers. The article concludes with a summary of current surveillance and screening recommendations.
癌症存活率的提高使得治疗的长期风险变得更为重要，尤其是对于儿童、青少年和青年人群体而言，由于预期寿命更长，对治疗的敏感性更高，他们面临的风险更大。在癌症登记处，癌症幸存者的后续恶性肿瘤现在占所有癌症诊断的 15%至 20%。大量研究旨在确定风险因素，但一些研究结果存在争议。只有来自大型队列的、具有详细个体治疗信息的且对所谓的“继发性癌症”进行核实的数据才能增加一些知识，因为它们的主要困难是大多数二级癌症部位的事件数量较少，这会影响统计结果。在对文献的回顾中，我们区分了第二原发癌和继发性癌症，并讨论了导致这种继发性癌症风险增加的因素。本文最后总结了目前的监测和筛查建议。
