头颈部癌症患者第二原发肿瘤的特异性 Cox 比例风险模型：一项 RONCDOC 研究。
A cause-specific Cox model for second primary tumors in patients with head and neck cancer: A RONCDOC study.
机构信息
Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Department of Public Health, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Center for Medical Decision Making, Rotterdam, The Netherlands.
出版信息
Head Neck. 2021 Jun;43(6):1881-1889. doi: 10.1002/hed.26666. Epub 2021 Mar 3.
BACKGROUND
The aim of this study was to identify risk factors for the development of second primary tumors (SPTs) in the head and neck region, lungs, and esophagus in patients with head and neck cancer.
METHODS
We collected data from 1581 patients. A cause-specific Cox model for the development of an SPT was fitted, accounting for the competing risks residual/recurrent tumor and mortality.
RESULTS
Of all patients, 246 (15.6%) developed SPTs. Analysis showed that tobacco and alcohol use, comorbidity, and the oral cavity subsite were risk factors for SPTs. The C-index, the discriminative accuracy, of the model for SPT was 0.65 (95% confidence interval, 0.61-0.68).
CONCLUSIONS
Our results show that there is potential to identify patients who have an increased risk to develop an SPT. This might increase their survival chances and quality of life. More research is needed to provide head and neck clinicians with definitive recommendations.
背景
本研究旨在确定头颈部癌症患者发生头颈部、肺部和食管第二原发肿瘤（SPT）的风险因素。
方法
我们收集了 1581 名患者的数据。建立了头颈部 SPT 发生的特定原因 Cox 模型，考虑了竞争风险残留/复发性肿瘤和死亡率。
结果
所有患者中，有 246 名（15.6%）发生了 SPT。分析表明，烟草和酒精使用、合并症和口腔部位是 SPT 的危险因素。该模型对头颈部 SPT 的 C 指数，即区分准确性为 0.65（95%置信区间，0.61-0.68）。
结论
我们的结果表明，有可能识别出发生 SPT 风险增加的患者。这可能会增加他们的生存机会和生活质量。需要进一步研究为头颈部临床医生提供明确的建议。
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