儿童肿瘤存活者需要长期监护

创作:hx 审核:hx 01月11日
在美国,儿童肿瘤的存活率能达到80%,但是随后发生新的原发性恶性肿瘤(SMN)的概率是一般人的2倍,并且这种风险长期存在,是导致其随后死亡的重要原因之一;
在原先放射疗法部位周围发生SMN的风险增加,并随放射剂量的增加而风险增加;
烷基化和蒽环类化疗药物的使用也会增加SMN的风险;
患者自身情况以及潜在的遗传易感性也会影响SMN的发生;
儿童肿瘤幸存者的长期监测和干预策略需要进一步改进,以减少SMN,提高存活率。
延伸阅读

Risk, Risk Factors, and Surveillance of Subsequent Malignant Neoplasms in Survivors of Childhood Cancer: A Review

儿童肿瘤存活者随后发生恶性肿瘤的风险、危险因素以及监测:一项综述

2018-07-20, Article, 10.1200/JCO.2017.76.7764more

Abstract:
Subsequent malignant neoplasms (SMNs) in childhood cancer survivors cause substantial morbidity and mortality. This review summarizes recent literature on SMN epidemiology, risk factors, surveillance, and interventions. Survivors of childhood cancer experience long-term increased SMN risk compared with the general population, with a greater than twofold increased solid tumor risk extending beyond age 40 years. There is a dose-dependent increased risk for solid tumors after radiotherapy, with the highest risks for tumors occurring in or near the treatment field (eg, greater than fivefold increased risk for breast, brain, thyroid, skin, bone, and soft tissue malignancies). Alkylating and anthracycline chemotherapies increase the risk for development of several solid malignancies in addition to acute leukemia/myelodysplasia, and these risks may be modified by other patient characteristics, such as age at exposure and, potentially, inherited genetic susceptibility. Strategies for identifying survivors at risk and initiating long-term surveillance have improved and interventions are underway to improve knowledge about late-treatment effects among survivors and caregivers. Better understanding of treatment-related risk factors and genetic susceptibility holds promise for refining surveillance strategies and, ultimately, upfront cancer therapies.

First Authors:
Lucie M Turcotte

Correspondence Authors:
Tara O Henderson

All Authors:
Lucie M Turcotte,Joseph P Neglia,Raoul C Reulen,Cecile M Ronckers,Flora E van Leeuwen,Lindsay M Morton,David C Hodgson,Yutaka Yasui,Kevin C Oeffinger,Tara O Henderson