Werner-Wasik M, Schmid C H, Bornstein L E, Madoc-Jones H
Department of Radiation Oncology, New England Medical Center, Tufts University School of Medicine, Boston, Massachusetts, USA.
Cancer. 1995 May 1;75(9):2281-5. doi: 10.1002/1097-0142(19950501)75:9<2281::aid-cncr2820750915>3.0.co;2-y.
The relative risk of second primary cancers was evaluated in 125 women with International Federation of Gynecology and Obstetrics (FIGO) Stages I and II cervical carcinoma treated radically with radiation therapy between January 1980 and December 1990.
Medical records of patients were reviewed to evaluate the incidence of second malignant neoplasms. Only tumors histologically proven were scored. The annual 5-year age-specific cancer incidence data per 100,000 white women in the years 1981-1985 were obtained from the National Cancer Institute's Surveillance, Epidemiology and End Results database. The relative risks were calculated as the ratio of observed-to-expected numbers of second cancers, using person-years at risk accumulated for each individual in the study.
During the follow-up time (through December 1992), 10 women whose median age was 65.5 years at the time cervical cancer was diagnosed were found to have 11 second primary cancers. Nine of these cancers were metachronous with regard to cervical cancer and included breast (4), lung (2), myeloma (1), non-Hodgkin's lymphoma (1) and vulva(1). The metachronous tumors were diagnosed at a median age of 74 years and at median follow-up time of 34 months. Two of the cancers were synchronous with cervical cancer and included bladder (1) and thyroid (1). All of the second tumors were located outside radiation fields. None of the patients with second tumors received chemotherapy during treatment for cervical carcinoma. The relative risk of developing a second cancer of any type was 2.31 (95% confidence interval [CI] = 1.15-4.13), whereas the relative risk of developing a metachronous breast cancer was 2.64 (95% CI = 0.72-6.75).
An increased risk of second primary cancers developing was observed among 125 patients with FIGO Stages I and II cervical carcinoma, which may suggest an abnormal genetic background and/or a common etiology for the initial and second tumors. The increased risk of breast cancer occurring as a second primary is in contrast with previously published studies reporting a decreased risk of breast cancer in survivors of cervical cancer.
对1980年1月至1990年12月期间接受根治性放射治疗的125例国际妇产科联盟（FIGO）I期和II期宫颈癌女性患者的第二原发性癌症的相对风险进行了评估。
回顾患者的病历以评估第二恶性肿瘤的发生率。仅对组织学确诊的肿瘤进行评分。1981 - 1985年每10万名白人女性的年度5岁年龄组癌症发病率数据来自美国国立癌症研究所的监测、流行病学和最终结果数据库。相对风险计算为观察到的第二癌症病例数与预期病例数之比，使用研究中每个个体累积的风险人年数。
在随访期间（至1992年12月），发现10名在诊断宫颈癌时中位年龄为65.5岁的女性患有11种第二原发性癌症。其中9种癌症与宫颈癌异时发生，包括乳腺癌（4例）、肺癌（2例）、骨髓瘤（1例）、非霍奇金淋巴瘤（1例）和外阴癌（1例）。异时性肿瘤诊断时的中位年龄为74岁，中位随访时间为34个月。2种癌症与宫颈癌同时发生，包括膀胱癌（1例）和甲状腺癌（1例）。所有第二肿瘤均位于放射野外。患有第二肿瘤的患者在宫颈癌治疗期间均未接受化疗。发生任何类型第二癌症的相对风险为2.31（95%置信区间[CI]=1.15 - 4.13）,而异时性乳腺癌的相对风险为2.64（95%CI = 0.72 - 6.75）。
在125例FIGO I期和II期宫颈癌患者中观察到第二原发性癌症发生风险增加，这可能提示初始肿瘤和第二肿瘤存在异常遗传背景和/或共同病因。作为第二原发性癌症发生的乳腺癌风险增加与先前发表的报告宫颈癌幸存者乳腺癌风险降低的研究结果相反。
