Navascués J A, Estellés C, Molina E, Martín Crespo R, Cerdá J, Aguilar F, Cantalejo A
Servicio de Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid.
Cir Pediatr. 1995 Jan;8(1):24-6.
More aggressiveness in treatment of childhood malignancies has had an evident impact on survival and rate of cure but, it has also allowed us to discover long-term effects of these treatments, and second malignant tumors of them. Between 1970 and 1993, 472 cases of malignant tumors in childhood were diagnosed in our department. Six of them (1.27%) developed a second tumor (five malignant and one benign). Relationship between first and second tumors are: seven years old boy, cervical lymphosarcoma-thyroid carcinoma; eleven years old boy, osteogenic sarcoma-vesical carcinoma: two years and six months old boy, cerebellar astrocytoma-soft tissue osteogenic sarcoma; five years old girl. Wilm's tumor-scapular osteogenic chondroma; one year and a half old girl, abdominal neuroblastoma-granulocytic sarcoma (chloroma); twelve years old boy. Hodgkin's disease-acute myeloblastic leukemia. All of them were clearly related to concogenic effect of radiation or chemotherapy.
对儿童恶性肿瘤治疗采取更积极的措施已对生存率和治愈率产生了明显影响,但这也使我们发现了这些治疗的长期影响以及由此引发的第二原发恶性肿瘤。1970年至1993年间,我科诊断出472例儿童恶性肿瘤病例。其中6例(1.27%)发生了第二肿瘤(5例恶性,1例良性)。第一肿瘤与第二肿瘤的关系如下:7岁男孩,颈部淋巴肉瘤 - 甲状腺癌;11岁男孩,骨肉瘤 - 膀胱癌;2岁6个月男孩,小脑星形细胞瘤 - 软组织骨肉瘤;5岁女孩,肾母细胞瘤 - 肩胛骨成骨性软骨瘤;1岁半女孩,腹部神经母细胞瘤 - 粒细胞肉瘤(绿色瘤);12岁男孩,霍奇金病 - 急性髓细胞白血病。所有这些都明显与放疗或化疗的致癌作用有关。