Johnson B E, Cortazar P, Chute J P
National Cancer Institute, Department of Medicine, National Naval Medical Center, Bethesda, MD 20889-5105, USA.
Semin Oncol. 1997 Aug;24(4):492-9.
The rate of developing second lung cancers and other aerodigestive tumors in patients who have been treated for both small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) is approximately 10-fold higher than other adult smokers. The risk of second lung cancers in patients surviving resection of NSCLC is approximately 1% to 2% per year. The series reported show that the patients who develop second NSCLCs tend to have early-stage NSCLC (predominantly stage I and II). The survival of patients after the second resection of lung cancer is similar to that of patients presenting with initial NSCLC. The risk of second lung cancers in patients surviving SCLC is 2% to 14% per patient per year and increases two- to seven-fold with the passage of time from 2 to 10 years. The risk of second lung cancers in patients treated for SCLC appears to be higher than that found in patients with NSCLC who were treated only with surgical resection. In addition, the chances of successful resection of second primary NSCLCs in patients who were treated for SCLC is much less than that for patients with metachronous lung cancers after an initial NSCLC. Patients treated for SCLC who continue to smoke cigarettes increase their rate of developing second lung cancers. The contribution of chest radiation and chemotherapy administration to the risk of developing second lung tumors remain to be defined but may be responsible for some of the increased risk in patients treated for SCLC compared to patients undergoing a surgical resection for NSCLC.
接受过小细胞肺癌（SCLC）和非小细胞肺癌（NSCLC）治疗的患者发生第二原发性肺癌和其他气消化道肿瘤的几率比其他成年吸烟者高约10倍。NSCLC切除术后存活患者发生第二原发性肺癌的风险约为每年1%至2%。报告的系列研究表明，发生第二原发性NSCLC的患者往往患有早期NSCLC（主要为I期和II期）。肺癌二次切除术后患者的生存率与初发NSCLC患者相似。SCLC存活患者发生第二原发性肺癌的风险为每年每位患者2%至14%，并随时间从2年到10年增加2至7倍。接受SCLC治疗的患者发生第二原发性肺癌的风险似乎高于仅接受手术切除治疗的NSCLC患者。此外，接受SCLC治疗的患者成功切除第二原发性NSCLC的几率远低于初发NSCLC后发生异时性肺癌的患者。继续吸烟的SCLC治疗患者发生第二原发性肺癌的几率会增加。胸部放疗和化疗给药对发生第二原发性肺肿瘤风险的影响尚待确定，但可能是SCLC治疗患者与接受NSCLC手术切除患者相比风险增加的部分原因。
