Boivin J F, Hutchison G B, Evans F B, Abou-Daoud K T, Junod B
Am J Epidemiol. 1986 Jun;123(6):993-1003. doi: 10.1093/oxfordjournals.aje.a114351.
The authors conducted a case-control study designed to evaluate the association between radiotherapy for a first primary cancer and subsequent leukemia risk. Study subjects were selected from four tumor registries (California, Connecticut, Kansas, and Massachusetts). Cases were subjects with two primary cancers; the second cancer was a leukemia diagnosed one year or more after the diagnosis of the first primary cancer. Control subjects were patients with single cancers. Two control subjects were chosen for each case matched for tumor registry, site of the first primary cancer, date of diagnosis of the first primary cancer, age, sex, and duration of survival after the first primary cancer. Separate analyses were carried out for chronic lymphatic leukemia (166 cases) and all other leukemias (232 cases). The relative risk of chronic lymphatic leukemia after radiotherapy was 0.7 and did not differ significantly from unity. For all other leukemias, relative risks were 1.6 after radiotherapy for first primary cancers of all sites, 2.4 after radiotherapy to trunk sites, 2.2 after radiotherapy for breast cancer, and 10.3 after radiotherapy for cancer of the corpus uteri. These relative risks for leukemias other than chronic lymphatic leukemia all differed significantly from unity.
作者开展了一项病例对照研究，旨在评估首次原发性癌症放疗与后续白血病风险之间的关联。研究对象选自四个肿瘤登记处（加利福尼亚州、康涅狄格州、堪萨斯州和马萨诸塞州）。病例为患有两种原发性癌症的受试者；第二种癌症为白血病，在首次原发性癌症诊断后一年或更长时间被诊断出来。对照受试者为患有单一癌症的患者。为每个病例选择两名对照受试者，根据肿瘤登记处、首次原发性癌症部位、首次原发性癌症诊断日期、年龄、性别以及首次原发性癌症后的生存时长进行匹配。对慢性淋巴细胞白血病（166例）和所有其他白血病（232例）分别进行了分析。放疗后慢性淋巴细胞白血病的相对风险为0.7，与1无显著差异。对于所有其他白血病，所有部位首次原发性癌症放疗后的相对风险为1.6，躯干部位放疗后为2.4，乳腺癌放疗后为2.2，子宫体癌放疗后为10.3。这些慢性淋巴细胞白血病以外的白血病的相对风险均与1有显著差异。
