Risk and prognosis of secondary lung cancer after radiation therapy for thoracic malignancies

IF 1.9 4区 医学 Q3 RESPIRATORY SYSTEM Clinical Respiratory Journal Pub Date : 2024-05-09 DOI:10.1111/crj.13760
Kang Chen, Chong Liu, Xueman Li, Tianyou Chen, Shan Liu, Fei Xiong, Zhou Zhang
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Abstract

Objective

Radiation therapy (RT) may increase the risk of second cancer. This study aimed to determine the association between exposure to radiotherapy for the treatment of thoracic cancer (TC) and subsequent secondary lung cancer (SLC).

Materials and Methods

The Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for TC. Univariate Cox regression analyses and multiple primary standardized incidence ratios (SIRs) were used to assess the risk of SLC. Subgroup analyses of patients stratified by latency time since TC diagnosis, age at TC diagnosis, and calendar year of TC diagnosis stage were also performed. Overall survival and SLC-related death were compared among the RT and no radiation therapy (NRT) groups by using Kaplan–Meier analysis and competitive risk analysis.

Results

In a total of 329 129 observations, 147 847 of whom had been treated with RT. And 6799 patients developed SLC. Receiving radiotherapy was related to a higher risk of developing SLC for TC patients (adjusted HR, 1.25; 95% CI, 1.19–1.32; P < 0.001). The cumulative incidence of developing SLC in TC patients with RT (3.8%) was higher than the cumulative incidence (2.9%) in TC patients with NRT(P). The incidence risk of SLC in TC patients who received radiotherapy was significantly higher than the US general population (SIR, 1.19; 95% CI, 1.14–1.23; P < 0.050).

Conclusions

Radiotherapy for TC was associated with higher risks of developing SLC compared with patients unexposed to radiotherapy.

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胸部恶性肿瘤放疗后继发肺癌的风险和预后。
目的:放射治疗(RT)可能会增加罹患第二种癌症的风险。本研究旨在确定为治疗胸腺癌(TC)而接受放射治疗与随后的继发性肺癌(SLC)之间的关系:对监测、流行病学和最终结果(SEER)数据库(1975 年至 2015 年)中的 TC 进行了查询。采用单变量 Cox 回归分析和多重一级标准化发病率比 (SIR) 评估 SLC 风险。此外,还按 TC 诊断后的潜伏时间、TC 诊断时的年龄和 TC 诊断阶段的日历年对患者进行了分组分析。通过卡普兰-梅耶分析和竞争风险分析,比较了放疗组和未放疗组的总生存率和SLC相关死亡:结果:在329 129名观察对象中,有147 847人接受了RT治疗。6799 名患者出现了 SLC。接受放疗与 TC 患者罹患 SLC 的较高风险有关(调整后 HR,1.25;95% CI,1.19-1.32;P 结论:TC 患者接受放疗与罹患 SLC 的较高风险有关(调整后 HR,1.25;95% CI,1.19-1.32;P):与未接受放疗的患者相比,TC 患者接受放疗后患 SLC 的风险更高。
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来源期刊
Clinical Respiratory Journal
Clinical Respiratory Journal 医学-呼吸系统
CiteScore
3.70
自引率
0.00%
发文量
104
审稿时长
>12 weeks
期刊介绍: Overview Effective with the 2016 volume, this journal will be published in an online-only format. Aims and Scope The Clinical Respiratory Journal (CRJ) provides a forum for clinical research in all areas of respiratory medicine from clinical lung disease to basic research relevant to the clinic. We publish original research, review articles, case studies, editorials and book reviews in all areas of clinical lung disease including: Asthma Allergy COPD Non-invasive ventilation Sleep related breathing disorders Interstitial lung diseases Lung cancer Clinical genetics Rhinitis Airway and lung infection Epidemiology Pediatrics CRJ provides a fast-track service for selected Phase II and Phase III trial studies. Keywords Clinical Respiratory Journal, respiratory, pulmonary, medicine, clinical, lung disease, Abstracting and Indexing Information Academic Search (EBSCO Publishing) Academic Search Alumni Edition (EBSCO Publishing) Embase (Elsevier) Health & Medical Collection (ProQuest) Health Research Premium Collection (ProQuest) HEED: Health Economic Evaluations Database (Wiley-Blackwell) Hospital Premium Collection (ProQuest) Journal Citation Reports/Science Edition (Clarivate Analytics) MEDLINE/PubMed (NLM) ProQuest Central (ProQuest) Science Citation Index Expanded (Clarivate Analytics) SCOPUS (Elsevier)
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