Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China.
Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Sci Rep. 2023 Mar 9;13(1):3968. doi: 10.1038/s41598-023-30812-8.
Although radiation therapy (RT) improves locoregional recurrence and overall survival in breast cancer (BC), it is not yet clear whether RT affects the risk of patients with BC developing second esophageal cancer (SEC). We enrolled patients with BC as their first primary cancer from nine registries in the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2018. Fine-Gray competing risk regressions were assessed to determine the cumulative incidence of SECs. The standardized incidence ratio (SIR) was used to compare the prevalence of SECs among BC survivors to that in the general population of the US. Kaplan-Meier survival analysis was applied to calculate the 10-year overall survival (OS) and cancer-specific survival (CSS) rates for SEC patients. Among the 523,502 BC patients considered herein, 255,135 were treated with surgery and RT, while 268,367 had surgery without radiotherapy. In a competing risk regression analysis, receiving RT was associated with a higher risk of developing an SEC in BC patients than that in the patients not receiving RT (P = .003). Compared to the general population of the US, the BC patients receiving RT showed a greater incidence of SEC (SIR, 1.52; 95% confidence interval [CI], 1.34-1.71, P < .05). The 10-year OS and CSS rates of SEC patients after RT were comparable to those of the SEC patients after no RT. Radiotherapy was related to an increased risk of developing SECs in patients with BC. Survival outcomes for patients who developed SEC after RT were similar to those after no RT.
尽管放射治疗（RT）可改善乳腺癌（BC）的局部区域复发和总生存，但目前尚不清楚 RT 是否会影响 BC 患者发生第二食管癌（SEC）的风险。我们从 1975 年至 2018 年期间，从监测、流行病学和最终结果（SEER）数据库中的 9 个登记处招募了作为其首次原发性癌症的 BC 患者。采用 Fine-Gray 竞争风险回归来确定 SEC 的累积发生率。标准化发病比（SIR）用于比较 BC 幸存者中 SEC 的患病率与美国一般人群中的 SEC 患病率。Kaplan-Meier 生存分析用于计算 SEC 患者的 10 年总生存率（OS）和癌症特异性生存率（CSS）。在考虑的 523,502 例 BC 患者中，有 255,135 例接受了手术和 RT 治疗，而 268,367 例仅接受了手术治疗。在竞争风险回归分析中，与未接受 RT 的患者相比，接受 RT 的 BC 患者发生 SEC 的风险更高（P=0.003）。与美国一般人群相比，接受 RT 的 BC 患者 SEC 的发病率更高（SIR，1.52；95%置信区间[CI]，1.34-1.71，P<0.05）。接受 RT 的 SEC 患者的 10 年 OS 和 CSS 率与未接受 RT 的 SEC 患者相似。RT 与 BC 患者 SEC 风险增加相关。接受 RT 后发生 SEC 的患者的生存结果与未接受 RT 后发生 SEC 的患者相似。
