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首页 » 癌症研究 » Cancer:胸部放射治疗肾母细胞瘤或可增加患者患乳腺癌的风险

Cancer:胸部放射治疗肾母细胞瘤或可增加患者患乳腺癌的风险

来源:生物谷 2014-10-29 09:31

2014年10月29日 讯 /生物谷BIOON/ --近日,来自美国西雅图Fred Hutchinson 癌症研究中心等处的研究人员通过研究表示,接受胸部放射治疗肾母细胞瘤的病人或许会因辐射的暴露而增加其日后患乳腺癌的风险,相关研究刊登于国际杂志Cancer上,本文研究揭示了癌症筛查指南或许应当被重新评估以促进肾母细胞瘤患者的早期诊断及其乳腺癌患病风险的提示。

肾母细胞瘤是一种罕见的儿童肾癌,其可以扩散至肺部,当癌症扩散后,病人需要进行12-14灰度的放射治疗;本文研究中,为了阐明是否射线的暴露会影响患者患乳腺癌的风险,研究人员Norman Breslow及其同事对儿童期进行肾母细胞瘤放射治疗的2500名青年女性进行了研究,在接受胸部放射的肾母细胞瘤女性幸存患者中,超过20%的个体在40岁时患上了乳腺癌,而未接受放射治疗的肾母细胞瘤患者患乳腺癌的比率仅为0.3%;接受腹部放射治疗肾母细胞瘤的患者患乳腺癌的风险仅为4%。

Breslow博士表示,如果患者的乳腺组织接受了20甚至更多灰度的放射治疗,那么指导方针中就需要加入针对儿童癌症幸存者患乳腺癌的早期筛查,这对于有效揭示肾母细胞瘤患者患乳腺癌的风险及对这些个体进行早期有效的治疗将非常关键。

在接下来的一篇社论中,研究者Jennifer Dean指出,高风险的肾母细胞瘤患者需要进行乳房x光的检查及乳腺MRI的检查,然而低于一半的患者并不认为其患乳腺癌的风险较高,由于乳腺癌筛查的监督在成人患者中普及度较低,因此未来研究人员还需要克服很多障碍来实现对肾母细胞瘤患者的乳腺癌风险分析来帮助确定患者的病情及治疗方法。(生物谷Bioon.com)

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Breast cancer in female survivors of Wilms tumor: A report from the National Wilms Tumor late effects study

Jane M. Lange MS1, Janice R. Takashima BA2, Susan M. Peterson MBA2, John A. Kalapurakal MD3, Daniel M. Green MD4 andNorman E. Breslow PhD1,2,*

BACKGROUND The standard treatment of pulmonary metastases in patients with Wilms tumor (WT) includes 12-gray radiotherapy (RT) to the entire chest. To the authors' knowledge, the risk of breast cancer (BC) in a large cohort of female survivors of WT has not previously been reported. METHODS A total of 2492 female participants in National Wilms Tumor Studies 1 through 4 (1969-1995) were followed from age 15 years through the middle of 2013 for incident BC. The median age at the time of last contact was 27.3 years. The authors calculated cumulative risk at age 40 years (CR40), hazard ratios (HR) by Cox regression, standardized incidence ratios (SIRs) relative to US population rates, and 95% confidence intervals (95% CIs). RESULTS The numbers of survivors with invasive BC divided by the numbers at risk were 16 of 369 (CR40, 14.8% [95% CI, 8.7-24.5]) for women who received chest RT for metastatic WT, 10 of 894 (CR40, 3.1% [95% CI, 1.3-7.41]) for those who received only abdominal RT, and 2 of 1229 (CR40, 0.3% [95% CI, 0.0-2.3]) for those who received no RT. The SIRs for these 3 groups were 27.6 (95% CI, 16.1-44.2) based on 5010 person-years (PY) of follow-up, 6.0 (95% CI, 2.9-11.0) based on 13,185 PY of follow-up, and 2.2 (95% CI, 0.3-7.8) based on 13,560 PY of follow-up, respectively. The risk was high regardless of the use of chest RT among women diagnosed with WT at age ≥10 years, with 9 of 90 women developing BC (CR40, 13.5% [95% CI, 5.6-30.6]; SIR, 23.6 [95% CI, 10.8-44.8] [PY, 1463]). CONCLUSIONS Female survivors of WT who were treated with chest RT had a high risk of developing early BC, with nearly 15% developing invasive disease by age 40 years. Current guidelines that recommend screening only those survivors who received ≥20 Gy of RT to the chest might be reevaluated. Cancer 2014. © 2014 American Cancer Society.

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