Krause J R, Ayuyang H Q, Ellis L D
Cancer. 1985 Feb 1;55(3):512-5. doi: 10.1002/1097-0142(19850201)55:3<512::aid-cncr2820550307>3.0.co;2-z.
Aggressive treatment of neoplastic disease has resulted in improved survival and, in some cases, cure of the primary malignancy. One of the most serious complications of such anticancer treatment has been the occurrence of an acute leukemia (primarily non-lymphocytic) several years after the successful treatment of the original neoplasm. Within the last 12 years, the authors have encountered 26 individuals who developed a second non-hematopoietic malignancy (excluding skin cancers) following primary aggressive treatment of a hematopoietic malignancy. All individuals had been treated with chemotherapy (24 of 26 with alkylating agents). The secondary tumors included lung (7), colon (6), gastric (4), bladder (3), esophageal (3), rectal (2) and pancreatic (1) tumors. The average time to development of the second malignancy in this series was 55.1 months, and the survival period following the diagnosis of the second malignancy averaged 7.3 months. It may be that aggressive anticancer treatment may be responsible for the emergence of a host of second non-hematopoietic carcinomas in addition to the now well established association with induced acute non-lymphocytic leukemias.
对肿瘤疾病的积极治疗已使生存率提高，在某些情况下，还治愈了原发性恶性肿瘤。这种抗癌治疗最严重的并发症之一是在成功治疗原发肿瘤数年之后发生急性白血病（主要是非淋巴细胞性）。在过去12年中，作者遇到了26例在造血系统恶性肿瘤接受初次积极治疗后发生第二种非造血系统恶性肿瘤（不包括皮肤癌）的患者。所有患者均接受过化疗（26例中有24例使用了烷化剂）。继发性肿瘤包括肺癌（7例）、结肠癌（6例）、胃癌（4例）、膀胱癌（3例）、食管癌（3例）、直肠癌（2例）和胰腺癌（1例）。该系列中第二种恶性肿瘤发生的平均时间为55.1个月，诊断出第二种恶性肿瘤后的生存期平均为7.3个月。除了现已明确的与诱导性急性非淋巴细胞白血病的关联外，积极的抗癌治疗可能也是导致许多第二种非造血系统癌症出现的原因。
