CAJ | 학술논문

目的分析早期结外鼻型NK/T细胞淋巴瘤(NKTCL)经治疗后生存超过3年患者第二原发恶性肿瘤(SMN)的发病风险.方法 1983年1月至2007年12月共174例ⅠE～ⅡE期NKTCL患者,经治疗后生存超过3年,其中50例接受单纯放疗,120例接受综合治疗,4例接受单纯化疗.采用中国2000年人口年龄构成比和国际通用的人口年龄构成比计算年龄调整标化发病率(中国)(ASRChina)和年龄调整标化发病率(世界)(ASR World).结果中位随诊8.3年(3.1～35.6年),9例(5.2％)患者在随诊期间发生SMN,距离初诊NKTCL的中位时间间隔为12.6年(0.9～ 18.5年).7例为实体肿瘤,2例为恶性淋巴瘤.5、10、15年的累积发病率分别为1.2％、2.4％和13.7％.全组患者粗发病率为531.6/105人年,ASR China和ASR World分别为294.5/105人年和243.7/105人年,年龄调整累积发病率(0～74岁)为22.4％.所有发病率均高于2010年中国癌症发病率报告中普通人群恶性肿瘤的发病率.结论早期NKTCL经治疗后获得长期生存患者的SMN发病率明显高于普通人群恶性肿瘤的发病率,NKTCL初诊后的10～ 15年是SMN的高发时段,长期生存NKTCL患者随诊时应注意SMN的可能性.
목적 분석조기결외비형NK/T세포림파류(NKTCL)경치료후생존초과3년환자제이원발악성종류(SMN)적발병풍험.방법 1983년1월지2007년12월공174례ⅠE～ⅡE기NKTCL환자,경치료후생존초과3년,기중50례접수단순방료,120례접수종합치료,4례접수단순화료.채용중국2000년인구년령구성비화국제통용적인구년령구성비계산년령조정표화발병솔(중국)(ASRChina)화년령조정표화발병솔(세계)(ASR World).결과 중위수진8.3년(3.1～35.6년),9례(5.2％)환자재수진기간발생SMN,거리초진NKTCL적중위시간간격위12.6년(0.9～ 18.5년).7례위실체종류,2례위악성림파류.5、10、15년적루적발병솔분별위1.2％、2.4％화13.7％.전조환자조발병솔위531.6/105인년,ASR China화ASR World분별위294.5/105인년화243.7/105인년,년령조정루적발병솔(0～74세)위22.4％.소유발병솔균고우2010년중국암증발병솔보고중보통인군악성종류적발병솔.결론 조기NKTCL경치료후획득장기생존환자적SMN발병솔명현고우보통인군악성종류적발병솔,NKTCL초진후적10～ 15년시SMN적고발시단,장기생존NKTCL환자수진시응주의SMN적가능성.
Objective To estimate risk and incidence of second malignant neoplasms (SMN) among long-term survivors of early stage extranodal nasal-type natural killer/T-cell lymphoma (NKTCL).Methods Between January 1983 and December 2007,174 patients with stage Ⅰ E and Ⅱ E NKTCL survived 3 or more years after treatment.Of them,50 patients were treated with radiotherapy alone,120 patients with combined modality therapy,and 4 patients with chemotherapy alone.The China 2010 population census data and Segi' s world population data were used for calculating the age-standardized cancer incidence rates.Results Median follow-up time was 8.3 years (3.1-35.6 years) for all patients.Nine (5.2 ％) SMN were recorded.The median time to SMN was 12.6 years (0.9-18.5 years) from diagnosis of NKTCL.Seven patients had solid tumors,and 2 had other type of malignant lymphomas.The cumulative incidence rates at 5-year,10-year and 15-year were 1.2 ％,2.4 ％ and 13.7 ％,respectively.The crude incidence was 531.6/105 person-years,the age-standardized rates by Chinese standard population (ASR China) and world standard population (ASR world) were 294.5/105 and 243.7/105,respectively,and the cumulative incidence rate (0-74 years old) was 22.4 ％.All of them were higher than the cancer incidence rates for general population in China in 2010.Conclusions A frequency of SMN in patients with NKTCL is higher than that expected in the general population.The patients have more risk for SMN during 10 to 15 years after diagnosis of NKTCL.Patients with long-term survival are at higher risk of SMN and should be carefully followed-up.