结肠癌患者在接受辅助化疗后的第二原发癌。

Second Cancer After Additive Chemotherapy in Patients With Colon Cancer.

机构信息

Department of Medicine II, Division of Hepatology, Division of Clinical Bioinformatics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Clinical Cooperation Unit Healthy Metabolism, Center for Preventive Medicine and Digital Health Baden-Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

Department of Medicine II, Division of Hepatology, Division of Clinical Bioinformatics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.

出版信息

Clin Colorectal Cancer. 2022 Dec;21(4):354-361. doi: 10.1016/j.clcc.2022.07.002. Epub 2022 Jul 16.

DOI:10.1016/j.clcc.2022.07.002

PMID:35934636

Abstract

BACKGROUND

Additive chemotherapeutic treatment of UICC-stage -III / IV colon cancer with fluorouracil, leucovorin and oxaliplatin is widely accepted as current standard of treatment after R0-resection. However, as patients.. survival is increasing, long-term side effects of chemotherapeutic agents such as second cancer development are becoming increasingly important.

PATIENTS

We therefore investigated a total of 2 856 Patients with UICC-stage III / IV colon cancer, 223 of whom (7.8%) had developed a subsequent second cancer.

RESULTS

Median follow-up was 73.2 months (range 209.9 months, 95%-CI 69.8-76.9). Most frequent second cancers were prostate cancer (18.4%), colon cancer (16.1%), breast cancers (8.1%), lung cancer (8.1%), rectal cancer (4.9%) and uterine cancer (4.9%). However, in comparison to non-treated patients this did not represent a significantly increased risk for subsequent second cancer in patients after treatment with additive chemotherapy. Of interest, our data suggest a significantly decreased second cancer rate in patients treated with FOLFOX compared to FUFOL for additive treatment.

CONCLUSIONS

Second cancer development was not increased after additive chemotherapy for colon cancer, which is a novel aspect in the ongoing discussions on reduction of adjuvant treatment to 3 months or treatment of lymph node negative patients. Novelty and Impact Statement To our knowledge, this is the first population-based study analyzing second cancer development after additive chemotherapy in patients with UICC III-IV colon cancer. The results have an important impact on the surveillance and long-term follow-up of cancer patients.

摘要

背景

UICC 分期-III/IV 期结直肠癌患者在接受氟尿嘧啶、亚叶酸钙和奥沙利铂的辅助化疗治疗已被广泛接受为 R0 切除术后的标准治疗方法。然而，随着患者生存时间的延长，化疗药物的长期副作用，如继发第二肿瘤的发生，变得越来越重要。

患者

我们因此调查了总共 2856 例 UICC 分期 III/IV 期结直肠癌患者，其中 223 例（7.8%）发生了继发第二肿瘤。

结果

中位随访时间为 73.2 个月（范围 209.9 个月，95%CI 69.8-76.9）。最常见的第二原发癌为前列腺癌（18.4%）、结肠癌（16.1%）、乳腺癌（8.1%）、肺癌（8.1%）、直肠癌（4.9%）和子宫癌（4.9%）。然而，与未治疗的患者相比，接受辅助化疗的患者发生继发第二肿瘤的风险并未显著增加。有趣的是，我们的数据表明，与 FUFOL 相比，接受 FOLFOX 治疗的患者继发第二肿瘤的发生率显著降低。