Johnson B E
Medicine Branch, Division of Clinical Sciences, National Cancer Institute, National Naval Medical Center, Bethesda, MD 20889-5105, USA.
J Natl Cancer Inst. 1998 Sep 16;90(18):1335-45. doi: 10.1093/jnci/90.18.1335.
Prospectively and retrospectively identified patient cohorts that were successfully treated for primary lung cancer have been followed to document the rate of development of and the effectiveness of treatment of second lung cancers. This review was performed to assess rates of second lung cancer development, factors associated with the development of these cancers, and the success of their treatment.
The MEDLINE database was searched to identify articles published in English concerning lung cancers, second primary cancers, treatment of these cancers, and patient survival.
The risk of developing a second lung cancer in patients who survived resection of a non-small-cell lung cancer is approximately 1%-2% per patient per year. Approximately one half of the patients who develop second non-small-cell lung cancers can have these tumors resected. The median survival from diagnosis of a second lung cancer in these patients is between 1 and 2 years, with a 5-year survival of approximately 20% (range, 4%-32%). The average risk of developing a second lung cancer in patients who survived small-cell lung cancer is approximately 6% per patient per year. For patients who survived small-cell cancer, the risk increases from approximately 2% to greater than 10% per patient per year 10 years after initial treatment. Only 7% (range, 6%-12%) of patients treated for small-cell lung cancer survive 2 years or more. Survivors who continue to smoke cigarettes have an increased risk of developing a second lung cancer.
In patients surviving an initial lung cancer, the cumulative risk for the development of a second primary lung cancer makes this cancer a common cause of death. The high risk of developing a second lung cancer makes patients with these cancers an important population for study of surveillance strategies and chemoprevention agents.
对前瞻性和回顾性确定的、已成功治疗原发性肺癌的患者队列进行随访，以记录第二原发性肺癌的发生率及治疗效果。本综述旨在评估第二原发性肺癌的发生率、与这些癌症发生相关的因素及其治疗的成功率。
检索MEDLINE数据库，以识别用英文发表的有关肺癌、第二原发性癌症、这些癌症的治疗及患者生存情况的文章。
非小细胞肺癌切除术后存活患者发生第二原发性肺癌的风险约为每年每位患者1%-2%。发生第二原发性非小细胞肺癌的患者中，约有一半的患者可切除这些肿瘤。这些患者中，从诊断出第二原发性肺癌起的中位生存期为1至2年，5年生存率约为20%（范围为4%-32%）。小细胞肺癌切除术后存活患者发生第二原发性肺癌的平均风险约为每年每位患者6%。对于小细胞肺癌存活患者，初始治疗10年后，风险从每年约2%增加至超过10%。接受小细胞肺癌治疗的患者中，只有7%（范围为6%-12%）能存活2年或更长时间。持续吸烟的幸存者发生第二原发性肺癌的风险增加。
在初始肺癌存活患者中，发生第二原发性肺癌的累积风险使这种癌症成为常见的死亡原因。发生第二原发性肺癌的高风险使这些癌症患者成为研究监测策略和化学预防药物的重要人群。
