Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China.
Clin Respir J. 2024 May;18(5):e13760. doi: 10.1111/crj.13760.
Radiation therapy (RT) may increase the risk of second cancer. This study aimed to determine the association between exposure to radiotherapy for the treatment of thoracic cancer (TC) and subsequent secondary lung cancer (SLC).
The Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for TC. Univariate Cox regression analyses and multiple primary standardized incidence ratios (SIRs) were used to assess the risk of SLC. Subgroup analyses of patients stratified by latency time since TC diagnosis, age at TC diagnosis, and calendar year of TC diagnosis stage were also performed. Overall survival and SLC-related death were compared among the RT and no radiation therapy (NRT) groups by using Kaplan-Meier analysis and competitive risk analysis.
In a total of 329 129 observations, 147 847 of whom had been treated with RT. And 6799 patients developed SLC. Receiving radiotherapy was related to a higher risk of developing SLC for TC patients (adjusted HR, 1.25; 95% CI, 1.19-1.32; P < 0.001). The cumulative incidence of developing SLC in TC patients with RT (3.8%) was higher than the cumulative incidence (2.9%) in TC patients with NRT(P). The incidence risk of SLC in TC patients who received radiotherapy was significantly higher than the US general population (SIR, 1.19; 95% CI, 1.14-1.23; P < 0.050).
Radiotherapy for TC was associated with higher risks of developing SLC compared with patients unexposed to radiotherapy.
放射治疗（RT）可能会增加发生第二原发癌的风险。本研究旨在确定接受胸部癌症（TC）治疗的放射治疗（RT）暴露与随后发生的继发性肺癌（SLC）之间的关联。
从 1975 年至 2015 年，对监测、流行病学和最终结果（SEER）数据库进行了 TC 检索。使用单变量 Cox 回归分析和多个主要标准化发病率比（SIR）来评估 SLC 的风险。还对 TC 诊断后潜伏期时间、TC 诊断时年龄和 TC 诊断分期的日历年分层的患者进行了亚组分析。通过 Kaplan-Meier 分析和竞争风险分析比较了 RT 和无放射治疗（NRT）组之间的总生存和 SLC 相关死亡。
在总共 329129 例观察中，有 147847 例接受了 RT 治疗。其中 6799 例患者发生了 SLC。接受放射治疗与 TC 患者发生 SLC 的风险增加相关（调整后的 HR，1.25；95%CI，1.19-1.32；P<0.001）。接受 RT 的 TC 患者发生 SLC 的累积发生率（3.8%）高于未接受 NRT 的 TC 患者（3.2%）（P<0.001）。接受放射治疗的 TC 患者发生 SLC 的风险显著高于美国一般人群（SIR，1.19；95%CI，1.14-1.23；P<0.050）。
与未接受放射治疗的患者相比，TC 的放射治疗与发生 SLC 的风险增加相关。
