文章：

儿童癌症幸存者的第二种癌症

Second cancers in survivors of childhood cancer

原文发布日期：2002-02-01

DOI: 10.1038/nrc722

类型: Review Article

开放获取: 否

要点：

1. Survivors of childhood cancer are at a 3–6-fold increased risk of developing a second cancer, compared with the general population. Although second cancers are a comparatively rare complication in cancer survivors, they are associated with significant morbidity and mortality.
2. For most second cancers, the risk decreases with increasing age of diagnosis of the first cancer; female gender is also associated with an increased risk of second cancers.
3. Radiation therapy increases the risk of several second cancers in a dose-dependent manner. Most second cancers associated with radiotherapy occur in or near the area that was irradiated, and most have a long latency.
4. Certain chemotherapeutic agents, particularly alkylating agents and topoisomerase II inhibitors, increase the risk of developing a second cancer. In some cases, specific genetic changes caused by these agents explain the increased risk of particular second cancers.
5. Emerging risk factors for second cancers include familial cancer syndromes, gene–environment interactions, lifestyle choices and other medical complications associated with treatment for the primary cancer.
6. By understanding the factors that increase risk of second cancers, we might be able to implement strategies to prevent them. For example, individuals known to be at increased risk of therapy-induced cancers can be treated with modified regimens that reduce this risk.

要点翻译：

1. 儿童癌症幸存者发生第二种癌症的风险比普通人群高3至6倍。尽管第二种癌症在癌症幸存者中是一种相对罕见的并发症，但其发病率和死亡率却很高。
2. 对于大多数第二种癌症，风险随着首次癌症诊断年龄的增加而降低；女性性别也与第二种癌症风险增加有关。
3. 放射治疗以剂量依赖的方式增加多种第二种癌症的风险。大多数与放疗相关的第二种癌症发生在放射区域内或附近，且多数具有较长的潜伏期。
4. 某些化疗药物，特别是烷化剂和拓扑异构酶II抑制剂，会增加发生第二种癌症的风险。在某些情况下，这些药物引起的特定基因变化解释了特定第二种癌症风险增加的原因。
5. 新出现的第二种癌症风险因素包括家族性癌症综合征、基因-环境相互作用、生活方式选择以及与原发性癌症治疗相关的其他医疗并发症。
6. 通过了解增加第二种癌症风险的因素，我们或许能够实施预防策略。例如，已知治疗诱发癌症风险增加的个体可以采用降低这种风险的改良方案进行治疗。

英文摘要：

More than 70% of children diagnosed with cancer can now be expected to be long-term survivors. However, the consequences of 'cure' might be considerable for the survivors of cancer: 60–70% of young adults who have survived childhood cancer will develop at least one medical disability as a result of their cancer or, more commonly, as a result of their therapy. Of these, the most devastating is a second cancer.

摘要翻译： 

超过70%被诊断为癌症的患儿如今有望成为长期幸存者。然而，“治愈”的后果对这些癌症幸存者而言可能相当严重：60%至70%的年轻成年人在童年癌症幸存后，将因癌症本身或更常见的治疗原因，发展出至少一种医学上的残疾。其中，最具毁灭性的是第二种癌症。

原文链接：

Second cancers in survivors of childhood cancer