AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between ...AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and sitespecific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account. Sensitivity tests were performed for attained-year adjustment and long-term survivors analysis. RESULTS A total of 28220 patients were analyzed. The 10-year cumulative SPM incidence was 7.8% [95% confidence interval(CI): 7.2%-8.2%] using a competing risk model. The most common sites of SPM were the lung, liver, and prostate. Radiotherapy was not associated with increased SPM risk in multi-variate Cox model(hazard ratio = 1.05, 95%CI: 0.91-1.21, P = 0.494). The SPM hazard remained unchanged in 10-yearsurvivors. In addition, no SPM risk difference was found between the preoperative radiotherapy and postoperative radiotherapy groups.CONCLUSION In this large population-based cohort study, we demonstrated that radiotherapy had no increase in SPM.展开更多
目的分析原发性腹膜癌(PPC)后继发第二原发恶性肿瘤(SPM)患者的流行病学及生存。方法从监测、流行病学和结果(SEER)数据库中收集1975-2016年诊断为PPC及继发SPM的患者。用Kaplan-Meier法进行生存分析。以患者死亡为竞争风险事件,使用Fin...目的分析原发性腹膜癌(PPC)后继发第二原发恶性肿瘤(SPM)患者的流行病学及生存。方法从监测、流行病学和结果(SEER)数据库中收集1975-2016年诊断为PPC及继发SPM的患者。用Kaplan-Meier法进行生存分析。以患者死亡为竞争风险事件,使用Fine and Gray模型计算累积发病率。结果共纳入符合条件的PPC患者1494例,其中发生SPM患者59例。PPC患者的5、10及20年SPM累积发病率分别为1.6%、4.7%及6.4%。发生SPM患者中位总生存时间为79.0个月,发生SPM的中位间隔时间为38.0个月,主要部位为乳腺(27.1%)、白血病(8.5%)、肺(8.5%)和膀胱(8.5%)。发生SPM后中位生存时间为25.0个月。结论PPC后SPM患者预后较差,应针对危险因素进行干预。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
目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院...目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院2012年1月至2016年2月LCSPM患者病例,采用卡方检验和Fisher精确概率法比较分类资料,Kaplan-Meier法进行生存分析,得到影响LCSPM患者生存的因素及生存率。结果:LCSPM患者第一原发癌最多见的是乳腺癌,其次是上呼吸消化道恶性肿瘤、甲状腺癌和结直肠癌;两原发癌的中位间隔时间是72个月,53.9%的患者超过5年;LCSPM患者2年生存率为71.2%,手术和分期可影响预后。结论:对于存在肿瘤史的病人,随访同一器官的同时其他器官的情况也不容忽视。及早发现、及早治疗并争取手术机会,LCSPM患者的生存期将显著延长。展开更多
文摘AIM To investigate second primary malignancy(SPM) risk after radiotherapy in rectal cancer survivors METHODS We used Taiwan's National Health Insurance Research Database to identify rectal cancer patients between 1996 and 2011. Surgery-alone, preoperative short course, preoperative long course, and post-operative radiotherapy groups were defined. The overall and sitespecific SPM incidence rates were compared among the radiotherapy groups by multivariate Cox regression, taking chemotherapy and comorbidities into account. Sensitivity tests were performed for attained-year adjustment and long-term survivors analysis. RESULTS A total of 28220 patients were analyzed. The 10-year cumulative SPM incidence was 7.8% [95% confidence interval(CI): 7.2%-8.2%] using a competing risk model. The most common sites of SPM were the lung, liver, and prostate. Radiotherapy was not associated with increased SPM risk in multi-variate Cox model(hazard ratio = 1.05, 95%CI: 0.91-1.21, P = 0.494). The SPM hazard remained unchanged in 10-yearsurvivors. In addition, no SPM risk difference was found between the preoperative radiotherapy and postoperative radiotherapy groups.CONCLUSION In this large population-based cohort study, we demonstrated that radiotherapy had no increase in SPM.
文摘目的分析原发性腹膜癌(PPC)后继发第二原发恶性肿瘤(SPM)患者的流行病学及生存。方法从监测、流行病学和结果(SEER)数据库中收集1975-2016年诊断为PPC及继发SPM的患者。用Kaplan-Meier法进行生存分析。以患者死亡为竞争风险事件,使用Fine and Gray模型计算累积发病率。结果共纳入符合条件的PPC患者1494例,其中发生SPM患者59例。PPC患者的5、10及20年SPM累积发病率分别为1.6%、4.7%及6.4%。发生SPM患者中位总生存时间为79.0个月,发生SPM的中位间隔时间为38.0个月,主要部位为乳腺(27.1%)、白血病(8.5%)、肺(8.5%)和膀胱(8.5%)。发生SPM后中位生存时间为25.0个月。结论PPC后SPM患者预后较差,应针对危险因素进行干预。
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.
文摘目的:收集第二原发癌为肺癌的多原发癌(lung cancer as second primary malignancy,LCSPM)患者临床特点、肿瘤部位和生存预后等临床信息进行回顾性分析,以期为指导临床实践提供一定的研究证据。方法:回顾性收集上海交通大学附属胸科医院2012年1月至2016年2月LCSPM患者病例,采用卡方检验和Fisher精确概率法比较分类资料,Kaplan-Meier法进行生存分析,得到影响LCSPM患者生存的因素及生存率。结果:LCSPM患者第一原发癌最多见的是乳腺癌,其次是上呼吸消化道恶性肿瘤、甲状腺癌和结直肠癌;两原发癌的中位间隔时间是72个月,53.9%的患者超过5年;LCSPM患者2年生存率为71.2%,手术和分期可影响预后。结论:对于存在肿瘤史的病人,随访同一器官的同时其他器官的情况也不容忽视。及早发现、及早治疗并争取手术机会,LCSPM患者的生存期将显著延长。
