Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of ...Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results： Forty-eight patients （13.5%） were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them （40/43） were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 （39.3%） achieved CR. 12 （42.8%） achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months （5.1-77.7 months）, while that of the rest 19 untreated patients （1 of 20 was lost to follow-up） was only 2.0 months （0.5 34.0 months）. There was no significant difference in the median survival and RR between 165 treated first primary SCLC （13.5 months and 77.6% respectively） and 28 treated secondary primary SCLC （11.3 months and 82.1% respectively） （P〉0.05）. The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter （3.5 months vs. 15 months, P〈0.05）. Conclusion： The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.展开更多
Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treati...Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treating GIST patients there with imatinib,a tyrosine kinase inhibitor,a small concern was raised：Ⅰ successively encountered patients who were newly diagnosed as having malignant neoplasms during the course of their treatment.Of the 70 GIST patients who were enrolled in our prospective study of imatinib therapy,seven suffered from second primary malignancies （SPMs）.One female GIST patient who suffered from advanced esophageal cancer died of the SPM,whereas the remaining six patients continued with their imatinib therapy and their prognoses were not affected by their SPMs.I reported on the risk of SPMs in GIST patients under imatinib therapy to an international journal of clinical oncology （1）.As the patient cohort of our study was so small in number to apply to statistical analysis,our observation was no more than a clinical alert.展开更多
Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs deve...Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs develop in a sporadic fashion,but familial occurrence,such as neurofibromatosis and Carney-triad,has also been reported （2）.The overall frequency of second tumors in different series varied from 4.5% to 33%.The most frequent types of GIST-associated cancers were gastrointestinal carcinomas （47%）,lymphoma/leukemia （7%）,carcinomas of prostate （9%）,breast （7%）,kidney （6%）,lung （5%）,female genital tract （5%）,carcinoid tumors （3%）,soft tissue and bone sarcomas （3%）,malignant melanoma （2%） and seminoma （1%） （1,3-5）.展开更多
Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated S...Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated SPMs.This study aimed to investigate the age-stratified association between radiotherapy and SPM risk in survivors of non-metastatic primary HNC.Methods:Using data from the Surveillance,Epidemiology,and End Results program(2004-2015),incidence rate ratios(IRRs)and standardized incidence ratios(SIRs)were evaluated for solid and hematologic SPMs associated with radiotherapy within different age groups.Follow-up for hematologic and solid SPMs began 2 and 5 years,respectively,after the diagnosis of first primary HNC.The IRRs for SPMs were compared between radiotherapy-exposed and unexposed groups using multivariable modified Poisson regression.The SIRs were computed as the ratio of observed cancers in the cohort to expected cases derived from sex-,age-,and calendar year-matched general population incidence rates.Results:The study included 75,2092-year survivors,with 73.2%being male and a median age of 60 years.Of these,58,063 had survived 5 years or more.Radiotherapy was associated with an increased risk of solid SPMs[IRR=1.16,95%confidence interval(CI)1.08-1.24;P<0.001].The associations varied significantly among young(aged 15-39 years),middle-aged(aged 40-64 years),and elderly(aged 65-89 years)patients.Specifically,radiotherapy was associated with an increased risk of solid SPMs in middle-aged patients(IRR=1.21,95%CI 1.11-1.32;P<0.001),and a decreased risk of hematologic SPMs in elderly patients(IRR=0.77,95%CI 0.60-0.99;P=0.045).Compared with the general population,young patients had an elevated risk of radiotherapy-associated second primary non-Hodgkin lymphoma(SIR=4.01,95%CI 1.47-8.74).Middle-aged patients showed the highest SIR for SPMs in the bones/joints(SIR=7.72,95%CI 4.32-12.73),while elderly patients had the highest SIR for second primary esophageal malignancies(SIR=3.87,95%CI 2.91-5.05).Males were more likely to develop solid SPMs compared to females.Conclusions:This study reveals an age-stratified association between radiotherapy and the risk of SPMs in HNC patients.These findings highlight the importance of considering patient age when making treatment decisions for HNC and suggest that long-term surveillance is necessary for high-risk groups.展开更多
Background:Prostate cancer(PCa)patients are at risk of developing second primary malignancies(SPMs),which can significantly shorten their survival.Understanding the risk of SPMs and associated factors is crucial to th...Background:Prostate cancer(PCa)patients are at risk of developing second primary malignancies(SPMs),which can significantly shorten their survival.Understanding the risk of SPMs and associated factors is crucial to the optimization of patient follow-up.Methods:This study focuses on PCa patients who were later diagnosed with SPMs using data from the Surveillance,Epidemiology,and End Results(SEER)database.Variables were carefully selected,and the data were analyzed using machine learning techniques combined with mul-tivariate Cox proportional hazards modeling.Subsequently,a nomogram was generated to predict the 1-,3-,and 5-year survival rates for SPMs patients.Additionally,a two-sample Mendelian randomization(TSMR)analysis was conducted to investigate the causal relationships between PCa and its top ten SPMs.Results:Among the variables,age,marital status,SPM site,M stage,American Joint Committee on Cancer(AJCC)stage,PCa surgery,and prostate-specific antigen(PSA)levels were identified as key prognostic factors through least absolute shrinkage and selection operator(LASSO)and backward stepwise regression.Based on these factors,a nomogram was developed to visually represent survival predictions,complemented by a web-based calculator for easy application.This nomogram,which serves as a supplement to traditional AJCC staging,demonstrated strong predictive power for 1-,3-,and 5-year survival,with area under the curve(AUC)values exceeding 0.85.Additionally,TSMR analysis revealed a causal link between PCa and urothelial carcinoma(UC).Conclusion:This study developed a nomogram for predicting survival in prostate cancer patients with secondary primary malignancies,enhancing prognosis accuracy.TSMR identified a causal link between PCa and UC.展开更多
Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed t...Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.展开更多
文摘Objective： To evaluate the clinical course of patients with small cell lung cancer （SCLC） as second primary malignancy. Methods： Among the 355 patients diagnosed with SCLC at Helen and Harry Gray Cancer Center of Hartford Hospital Connecticut USA between 1988 and 1998, the records of 48 patients, which had been diagnosed with other malignancies before their diagnosis of SCLC, were retro- spectively reviewed. Results： Forty-eight patients （13.5%） were diagnosed with other malignancies prior to their SCLC among which 43 had documented smoking history and 93% of them （40/43） were current/former smokers. Of the 28-second primary SCLC patients who were treated with standard method, 11 （39.3%） achieved CR. 12 （42.8%） achieved PR, and the RR was 82.1%. The median survival of the 28 treated with standard method was 11.3 months （5.1-77.7 months）, while that of the rest 19 untreated patients （1 of 20 was lost to follow-up） was only 2.0 months （0.5 34.0 months）. There was no significant difference in the median survival and RR between 165 treated first primary SCLC （13.5 months and 77.6% respectively） and 28 treated secondary primary SCLC （11.3 months and 82.1% respectively） （P〉0.05）. The patients who had prostate cancer were older and subjected to less treatments than those with skin cancer, so their survival was shorter than the latter （3.5 months vs. 15 months, P〈0.05）. Conclusion： The response and survival of the treated patients with SCLC as a second malignancy showed no difference as compared to the treated ones with SCLC only. Therefore, an active medical treatment is important to relieve symptom and prolong survival of the second primary SCLC patients.
文摘Niigata University Hospital is a regional center institution of cancer therapy where many patients with gastrointestinal stromal tumors （GISTs） are visiting to seek the latest treatment.During the time Ⅰ was treating GIST patients there with imatinib,a tyrosine kinase inhibitor,a small concern was raised：Ⅰ successively encountered patients who were newly diagnosed as having malignant neoplasms during the course of their treatment.Of the 70 GIST patients who were enrolled in our prospective study of imatinib therapy,seven suffered from second primary malignancies （SPMs）.One female GIST patient who suffered from advanced esophageal cancer died of the SPM,whereas the remaining six patients continued with their imatinib therapy and their prognoses were not affected by their SPMs.I reported on the risk of SPMs in GIST patients under imatinib therapy to an international journal of clinical oncology （1）.As the patient cohort of our study was so small in number to apply to statistical analysis,our observation was no more than a clinical alert.
文摘Gastrointestinal stromal tumor （GIST） is the most common mesenchymal malignancy of the gastrointestinal tract.GISTs may coexist with different types of cancer,either synchronous or metachronous （1）.Most GISTs develop in a sporadic fashion,but familial occurrence,such as neurofibromatosis and Carney-triad,has also been reported （2）.The overall frequency of second tumors in different series varied from 4.5% to 33%.The most frequent types of GIST-associated cancers were gastrointestinal carcinomas （47%）,lymphoma/leukemia （7%）,carcinomas of prostate （9%）,breast （7%）,kidney （6%）,lung （5%）,female genital tract （5%）,carcinoid tumors （3%）,soft tissue and bone sarcomas （3%）,malignant melanoma （2%） and seminoma （1%） （1,3-5）.
基金supported by the National Natural Science Foundation of China(82101069)the Beijing Natural Science Foundation(7242279),the Beijing Nova Program(20230484283)+2 种基金the Beijing Municipal Science&Technology Commission(Z221100007422130)the Open Project of State Key Laboratory of Trauma and Chemical Poisoning(SKLO202401)the Logistics Independent Research Project of PLA(C24LBJ032).
文摘Background:Second primary malignancies(SPMs)account for over 30%of total deaths in head and neck cancer(HNC)patients.The increasing use of radiotherapy raises concerns about the elevated risk of radiation-associated SPMs.This study aimed to investigate the age-stratified association between radiotherapy and SPM risk in survivors of non-metastatic primary HNC.Methods:Using data from the Surveillance,Epidemiology,and End Results program(2004-2015),incidence rate ratios(IRRs)and standardized incidence ratios(SIRs)were evaluated for solid and hematologic SPMs associated with radiotherapy within different age groups.Follow-up for hematologic and solid SPMs began 2 and 5 years,respectively,after the diagnosis of first primary HNC.The IRRs for SPMs were compared between radiotherapy-exposed and unexposed groups using multivariable modified Poisson regression.The SIRs were computed as the ratio of observed cancers in the cohort to expected cases derived from sex-,age-,and calendar year-matched general population incidence rates.Results:The study included 75,2092-year survivors,with 73.2%being male and a median age of 60 years.Of these,58,063 had survived 5 years or more.Radiotherapy was associated with an increased risk of solid SPMs[IRR=1.16,95%confidence interval(CI)1.08-1.24;P<0.001].The associations varied significantly among young(aged 15-39 years),middle-aged(aged 40-64 years),and elderly(aged 65-89 years)patients.Specifically,radiotherapy was associated with an increased risk of solid SPMs in middle-aged patients(IRR=1.21,95%CI 1.11-1.32;P<0.001),and a decreased risk of hematologic SPMs in elderly patients(IRR=0.77,95%CI 0.60-0.99;P=0.045).Compared with the general population,young patients had an elevated risk of radiotherapy-associated second primary non-Hodgkin lymphoma(SIR=4.01,95%CI 1.47-8.74).Middle-aged patients showed the highest SIR for SPMs in the bones/joints(SIR=7.72,95%CI 4.32-12.73),while elderly patients had the highest SIR for second primary esophageal malignancies(SIR=3.87,95%CI 2.91-5.05).Males were more likely to develop solid SPMs compared to females.Conclusions:This study reveals an age-stratified association between radiotherapy and the risk of SPMs in HNC patients.These findings highlight the importance of considering patient age when making treatment decisions for HNC and suggest that long-term surveillance is necessary for high-risk groups.
基金Student Innovation Capability Enhancement Program of Guangzhou Medical University,Grant/Award Numbers:2022 NO.67,2023 NO.7Special Funds for the Cultivation of Guangdong College Students'Scientific and Technological Innovation(“Climbing Program”Special Funds),Grant/Award Number:pdjh2023b0431。
文摘Background:Prostate cancer(PCa)patients are at risk of developing second primary malignancies(SPMs),which can significantly shorten their survival.Understanding the risk of SPMs and associated factors is crucial to the optimization of patient follow-up.Methods:This study focuses on PCa patients who were later diagnosed with SPMs using data from the Surveillance,Epidemiology,and End Results(SEER)database.Variables were carefully selected,and the data were analyzed using machine learning techniques combined with mul-tivariate Cox proportional hazards modeling.Subsequently,a nomogram was generated to predict the 1-,3-,and 5-year survival rates for SPMs patients.Additionally,a two-sample Mendelian randomization(TSMR)analysis was conducted to investigate the causal relationships between PCa and its top ten SPMs.Results:Among the variables,age,marital status,SPM site,M stage,American Joint Committee on Cancer(AJCC)stage,PCa surgery,and prostate-specific antigen(PSA)levels were identified as key prognostic factors through least absolute shrinkage and selection operator(LASSO)and backward stepwise regression.Based on these factors,a nomogram was developed to visually represent survival predictions,complemented by a web-based calculator for easy application.This nomogram,which serves as a supplement to traditional AJCC staging,demonstrated strong predictive power for 1-,3-,and 5-year survival,with area under the curve(AUC)values exceeding 0.85.Additionally,TSMR analysis revealed a causal link between PCa and urothelial carcinoma(UC).Conclusion:This study developed a nomogram for predicting survival in prostate cancer patients with secondary primary malignancies,enhancing prognosis accuracy.TSMR identified a causal link between PCa and UC.
文摘Cancers of the head and neck account for more than half a million cases worldwide annually, with a significant majority diagnosed as squamous cell carcinoma(HNSCC). Imaging studies such as contrast-enhanced computed tomography(CT), magnetic resonance imaging(MRI) and ^(18)F-2-fluoro-2-deoxy-D-glucose positron-emission tomography/computed tomography(^(18)F-FDG PET/CT) are widely used to determine the presence and extent of tumors and metastatic disease, both before and after treatment. Advances in PET/CT imaging have allowed it to emerge as a superior imaging modality compared to both CT and MRI, especially in detection of carcinoma of unknown primary, cervical lymph node metastasis, distant metastasis, residual/recurrent cancer and second primary tumors, often leading to alteration in management. PET/CT biomarker may further provide an overall assessment of tumor aggressiveness with prognostic implications. As new developments emerged leading to better understanding and use of PET/CT in head and neck oncology, the aim of this article is to review the roles of PET/CT in both pre- and post-treatment management of HNSCC and PET-derived parameters as prognostic indicators.
