Acute lymphoblastic leukemia(ALL)is a common pediatric cancer.The second malignant neoplasms(SMNs)in long-term survivors of pediatric ALL are relatively rare.Herein we report a 10-year-old girl who was diagnosed as pr...Acute lymphoblastic leukemia(ALL)is a common pediatric cancer.The second malignant neoplasms(SMNs)in long-term survivors of pediatric ALL are relatively rare.Herein we report a 10-year-old girl who was diagnosed as primitive neuroectodermal tumor(PNET)5 years after the initial diagnosis of ALL with radiotherapy・free treatment.PNET is an exceedingly rare neoplasm in SMNs of survivors of childhood ALL.It is predisposed to be misdiagnosed and the pathogenesis is unclear.The outcome is poor.Long-term follow-up is necessary for the survival children of ALL.展开更多
Objective： To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods： Clinical data of 47 cases of uterine neoplasms occurred following...Objective： To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods： Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results： The median age at uterine neoplasms diagnosis was 62 years （range： 38-77 years）, and the median latency period from initial therapy to development of uterine neoplasms was 14 years （range： 5-35 years）. Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma （UPSC）. Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows： stage Ⅰb, 1 case; stage Ⅰc, 2 cases; stage Ⅱ, 6; stage Ⅲa, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 （include 3 UPSC patients）, seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences （23.3%）, at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients occurred recurrence （35.9%）, at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion： The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.展开更多
目的探讨食管癌放射治疗(简称放疗)后发生第二原发性肿瘤风险及对患者长期生存预后的影响。方法从SEER(the surveillance,epidemiology,and end results)数据库中选入已确诊食管癌的患者。采用Fine-Gray竞争风险回归估计食管癌发生第二...目的探讨食管癌放射治疗(简称放疗)后发生第二原发性肿瘤风险及对患者长期生存预后的影响。方法从SEER(the surveillance,epidemiology,and end results)数据库中选入已确诊食管癌的患者。采用Fine-Gray竞争风险回归估计食管癌发生第二原发性肿瘤的累积发生率,Cox比例风险回归预测第二原发性肿瘤发生的独立风险因素,Kaplan-Meier和Cox回归分析法用于评估第二原发性肿瘤患者的生存结局。结果从SEER数据库中共筛选18221例确诊食管癌的患者,其中有9724例(53.37%)患者接受放疗(放疗组),8497例(46.63%)患者未接受放疗(非放疗组)。在12个月的潜伏期后,放疗组和非放疗组分别有745例和811例患者发生了第二原发性肿瘤。放疗组和非放疗组发生第二原发性肿瘤患者的累积竞争风险发生率分别为9.35%和11.65%,差异有统计学意义(P=0.025)。器官特异性分析表明,放疗组发生第二原发性肿瘤患者在甲状腺部的累积竞争风险发生率显著高于非放疗组发生第二原发性肿瘤患者(1.03%比1.04%,P=0.022),但在前列腺部的累积竞争风险发生率显著低于非放疗组发生第二原发性肿瘤患者(2.95%比4.12%,P<0.001),两组患者在其他部位发生第二原发性肿瘤患者的累积竞争风险发生率比较差异均无统计学意义(均P>0.05)。多因素Cox回归分析表明,放疗组患者在肺部、骨髓部和膀胱部发生第二原发性肿瘤的风险显著高于非放疗组(均P<0.05),而两组患者在前列腺部和甲状腺部发生第二原发性肿瘤的风险比较差异均无统计学意义(均P>0.05)。放疗组在肺部(13.1%比19.52%)、骨髓部(13.1%比19.52%)、胃部(10.69%比37.8%)和甲状腺部(48.7%比69.6%)发生第二原发性肿瘤患者10年OS率较仅原发性肿瘤患者显著降低(均P<0.05),而非放疗组发生第二原发性肿瘤患者的10年OS率与仅患有原发性肿瘤患者相比无显著差异(P>0.05)。结论原发性食管癌患者在接受放疗后,甲状腺部发生第二原发性肿瘤的风险显著增加,且患者10年OS率相对更低。因此,对于接受放疗的食管癌患者,尤其是年轻患者,放疗后,应定期监测甲状腺部位,以便及时发现并预防第二原发性肿瘤的风险。展开更多
Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was...Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.展开更多
Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the ...Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the incidence and associated risk factors in older patients remain poorly understood.This study aimed to assess the incidence,identify risk factors,and evaluate their impact on survival outcomes among older patients with hematological malignancies.Methods:This retrospective single-center study analyzed data from 163 patients,focusing on the occurrence of second primary neoplasms.Cumulative incidence rates were calculated,and risk factor analysis was conducted using a competing risk model.Results:Among 124 eligible patients with a total follow-up duration of 572.57 person-years,the incidence rate of second primary neoplasms was 15.72/1000 person-years.The standardized incidence ratio(SIR)was 0.81(95%confidence interval[CI][0.39–1.48],P=0.518).History of radiotherapy emerged as a significant risk factor(subdistribution hazard ratio[SHR]=21.61[2.81–166.14],P=0.003),whereas regular natural killer(NK)cell infusion was associated with reduced risk(SHR=3.25 e8[9.81 e9–1.08 e7],P<0.001).Conclusions:These findings underscore the importance of informing older patients with hematological malignancies about the long-term risks of second primary neoplasms.Healthcare providers should carefully weigh risk factors when formulating treatment strategies.The results are valuable for investigating the fundamental principles underlying the occurrence and progression of second primary neoplasms.展开更多
文摘Acute lymphoblastic leukemia(ALL)is a common pediatric cancer.The second malignant neoplasms(SMNs)in long-term survivors of pediatric ALL are relatively rare.Herein we report a 10-year-old girl who was diagnosed as primitive neuroectodermal tumor(PNET)5 years after the initial diagnosis of ALL with radiotherapy・free treatment.PNET is an exceedingly rare neoplasm in SMNs of survivors of childhood ALL.It is predisposed to be misdiagnosed and the pathogenesis is unclear.The outcome is poor.Long-term follow-up is necessary for the survival children of ALL.
文摘Objective： To study the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods： Clinical data of 47 cases of uterine neoplasms occurred following radiation therapy for cervical carcinoma were retrospectively reviewed. Results： The median age at uterine neoplasms diagnosis was 62 years （range： 38-77 years）, and the median latency period from initial therapy to development of uterine neoplasms was 14 years （range： 5-35 years）. Thirty of 47 cases were endometrial carcinoma, of which 3 were uterine papillary serous carcinoma （UPSC）. Seventeen of 47 patients were uterine sarcoma, all of those were carcinosarcoma. The distribution by stage, grade, and histology of 30 cases of endometrial carcinoma was as follows： stage Ⅰb, 1 case; stage Ⅰc, 2 cases; stage Ⅱ, 6; stage Ⅲa, 4; stage Ⅲb, 2; stage Ⅲc, 11; stage Ⅳ, 4 cases; grade 1, two cases; grade 2, nine; grade 3 （include 3 UPSC patients）, seventeen; unknown grade, two; endometriod, 27; UPSC, 3 cases; 7 of 30 cases of endometrial carcinoma had recurrences （23.3%）, at median time to recurrence was 24 months, and their median survival time was 26 months. The overall 3- and 5-year survival rates were 60% and 38%, respectively. Of the 17 cases of uterine sarcoma, the median survival was 10 months, 6 patients occurred recurrence （35.9%）, at a median time to recurrence was 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rates were 12% and 0, respectively. Conclusion： The main uterine neoplasms development after radiation therapy for cervical carcinoma is endometrial carcinomas, of which there is a preponderance of high-risk histological subtypes and a poor prognosis. Most of the uterine sarcomas occurred following radiation therapy for cervical carcinoma are carcinosarcomas and the prognosis is very poor.
文摘目的探讨食管癌放射治疗(简称放疗)后发生第二原发性肿瘤风险及对患者长期生存预后的影响。方法从SEER(the surveillance,epidemiology,and end results)数据库中选入已确诊食管癌的患者。采用Fine-Gray竞争风险回归估计食管癌发生第二原发性肿瘤的累积发生率,Cox比例风险回归预测第二原发性肿瘤发生的独立风险因素,Kaplan-Meier和Cox回归分析法用于评估第二原发性肿瘤患者的生存结局。结果从SEER数据库中共筛选18221例确诊食管癌的患者,其中有9724例(53.37%)患者接受放疗(放疗组),8497例(46.63%)患者未接受放疗(非放疗组)。在12个月的潜伏期后,放疗组和非放疗组分别有745例和811例患者发生了第二原发性肿瘤。放疗组和非放疗组发生第二原发性肿瘤患者的累积竞争风险发生率分别为9.35%和11.65%,差异有统计学意义(P=0.025)。器官特异性分析表明,放疗组发生第二原发性肿瘤患者在甲状腺部的累积竞争风险发生率显著高于非放疗组发生第二原发性肿瘤患者(1.03%比1.04%,P=0.022),但在前列腺部的累积竞争风险发生率显著低于非放疗组发生第二原发性肿瘤患者(2.95%比4.12%,P<0.001),两组患者在其他部位发生第二原发性肿瘤患者的累积竞争风险发生率比较差异均无统计学意义(均P>0.05)。多因素Cox回归分析表明,放疗组患者在肺部、骨髓部和膀胱部发生第二原发性肿瘤的风险显著高于非放疗组(均P<0.05),而两组患者在前列腺部和甲状腺部发生第二原发性肿瘤的风险比较差异均无统计学意义(均P>0.05)。放疗组在肺部(13.1%比19.52%)、骨髓部(13.1%比19.52%)、胃部(10.69%比37.8%)和甲状腺部(48.7%比69.6%)发生第二原发性肿瘤患者10年OS率较仅原发性肿瘤患者显著降低(均P<0.05),而非放疗组发生第二原发性肿瘤患者的10年OS率与仅患有原发性肿瘤患者相比无显著差异(P>0.05)。结论原发性食管癌患者在接受放疗后,甲状腺部发生第二原发性肿瘤的风险显著增加,且患者10年OS率相对更低。因此,对于接受放疗的食管癌患者,尤其是年轻患者,放疗后,应定期监测甲状腺部位,以便及时发现并预防第二原发性肿瘤的风险。
文摘Testicular cancer survival rates improved dramatically after cisplatin-based therapy was introduced in the 1970s. However, chemotherapy and radiation therapy are potentially carcinogenic. The purpose of this study was to estimate the risk of developing second primary cancers including the risk associated with primary histologic type （seminoma and non-seminoma） among testicular cancer survivors in Germany. We identified 16 990 and 1401 cases of testicular cancer in population-based cancer registries of East Germany （1961-1989 and 1996-2008） and Saarland （a federal state in West Germany; 1970-2008）, respectively. We estimated the risk of a second primary cancer using standardized incidence ratios （SIRs） with 95% confidence intervals （95% Cls）. To determine trends, we plotted model-based estimated annual SIRs. In East Germany, a total of 301 second primary cancers of any location were observed between 1961 and 1989 （SIR： 1.9; 95% Ch 1.7-2.1）, and 159 cancers （any location） were observed between 1996 and 2008 （SIR： 1.7; 95% Ch 1.4-2.0）. The SIRs for contralateral testicular cancer were increased in the registries with a range from 6.0 in Saarland to 13.9 in East Germany. The SIR for seminoma, in particular, was higher in East Germany compared to the other registries. We observed constant trends in the model-based SIRs for contralateral testicular cancers. The majority of reported SIRs of other cancer sites including histology-specific risks showed low precisions of estimated effects, likely due to small sample sizes. Testicular cancer patients are at increased risk especially for cancers of the contralateral testis and should receive intensive follow-ups.
基金supported by the National Key Research and Development Plan of China(No.2020YFC2002706-2)the National Clinical Research Center for Geriatrics of China Open Project(No.NCRCGPLAGH-2022011).
文摘Background:Patients with hematological malignancies face an increased risk of developing second primary neoplasms due to various factors,including immune system compromise and chemotherapy-related effects.However,the incidence and associated risk factors in older patients remain poorly understood.This study aimed to assess the incidence,identify risk factors,and evaluate their impact on survival outcomes among older patients with hematological malignancies.Methods:This retrospective single-center study analyzed data from 163 patients,focusing on the occurrence of second primary neoplasms.Cumulative incidence rates were calculated,and risk factor analysis was conducted using a competing risk model.Results:Among 124 eligible patients with a total follow-up duration of 572.57 person-years,the incidence rate of second primary neoplasms was 15.72/1000 person-years.The standardized incidence ratio(SIR)was 0.81(95%confidence interval[CI][0.39–1.48],P=0.518).History of radiotherapy emerged as a significant risk factor(subdistribution hazard ratio[SHR]=21.61[2.81–166.14],P=0.003),whereas regular natural killer(NK)cell infusion was associated with reduced risk(SHR=3.25 e8[9.81 e9–1.08 e7],P<0.001).Conclusions:These findings underscore the importance of informing older patients with hematological malignancies about the long-term risks of second primary neoplasms.Healthcare providers should carefully weigh risk factors when formulating treatment strategies.The results are valuable for investigating the fundamental principles underlying the occurrence and progression of second primary neoplasms.
