文章：

直肠乙状结肠癌放疗后膀胱癌的发病率、特征及生存率分析

Incidence, Characteristics and Survival Rates of Bladder Cancer after Rectosigmoid Cancer Radiation

原文发布日期：29 June 2024

DOI: 10.3390/cancers16132404

类型: Article

开放获取: 是

英文摘要：

Background: Historical external beam radiation therapy (EBRT) for rectosigmoid cancer (RCa) predisposed patients to an increased risk of secondary bladder cancer (BCa). However, no contemporary radiotherapy studies are available. We addressed this knowledge gap. Materials and methods: Within the Surveillance, Epidemiology, and End Results database (2000–2020), we identified non-metastatic RCa patients who either underwent radiotherapy (EBRT+) or did not (EBRT-). Cumulative incidence plots and multivariable competing risk regression models (CRR) were fitted to address rates of BCa after RCa. In the subgroup of BCa patients, the same methodology addressed BCa-specific mortality (BCSM) according to EBRT exposure status. Results: Of the 188,658 non-metastatic RCa patients, 54,562 (29%) were EBRT+ vs. 134,096 (73%) who were EBRT-. In the cumulative incidence plots, the ten-year BCa rates were 0.7% in EBRT+ vs. 0.7% in EBRT- patients (p= 0.8). In the CRR, EBRT+ status was unrelated to BCa rates (multivariable HR: 1.1,p= 0.8). In the subgroup of 1416 patients with BCa after RCa, 443 (31%) were EBRT+ vs. 973 (69%) who were EBRT-. In the cumulative incidence plots, the ten-year BCSM rates were 10.6% in EBRT+ vs. 12.1% in EBRT- patients (p= 0.7). In the CRR, EBRT+ status was unrelated to subsequent BCSM rates (multivariable HR: 0.9,p= 0.9). Conclusion: Although historical EBRT for RCa predisposed patients to higher BCa rates, contemporary EBRT for RCa is not associated with increased subsequent BCa risk. Moreover, in patients with BCa after RCa, exposure to EBRT does not affect BCSM.

摘要翻译： 

背景：历史上针对直肠乙状结肠癌（RCa）的外照射放疗（EBRT）会增加患者继发膀胱癌（BCa）的风险。然而，目前尚缺乏现代放疗技术相关研究。本研究旨在填补这一知识空白。 材料与方法：基于监测、流行病学和最终结果数据库（2000-2020年），我们筛选出接受放疗（EBRT+）与未接受放疗（EBRT-）的非转移性RCa患者。通过累积发病率曲线和多变量竞争风险回归模型（CRR）分析RCa后BCa发生率。在继发BCa患者亚组中，采用相同方法根据EBRT暴露状态评估膀胱癌特异性死亡率（BCSM）。 结果：在188,658例非转移性RCa患者中，54,562例（29%）为EBRT+组，134,096例（71%）为EBRT-组。累积发病率曲线显示，两组患者十年BCa发生率均为0.7%（p=0.8）。CRR分析表明EBRT+状态与BCa发生率无显著关联（多变量HR：1.1，p=0.8）。在1,416例RCa后继发BCa患者中，443例（31%）为EBRT+组，973例（69%）为EBRT-组。累积发病率曲线显示，EBRT+组十年BCSM率为10.6%，EBRT-组为12.1%（p=0.7）。CRR分析显示EBRT+状态与后续BCSM率无显著关联（多变量HR：0.9，p=0.9）。 结论：虽然历史上RCa的EBRT治疗会增加BCa发生率，但现代EBRT技术与继发BCa风险增加无关。此外，在RCa后继发BCa的患者中，EBRT暴露不影响BCSM。

原文链接：

Incidence, Characteristics and Survival Rates of Bladder Cancer after Rectosigmoid Cancer Radiation