Second primary malignancies after stereotactic body radiotherapy vs surgery for early-stage lung cancer: a U.S. population-based study, 2010-2015

IF 3.5 Q3 Medicine

Cancer treatment and research communications Pub Date : 2026-01-01 Epub Date: 2026-04-08 DOI:10.1016/j.ctarc.2026.101211

Lianfang Ni, Zhigang Zhang, Zhonghui Liu, Xinmin Liu

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引用次数: 0

Abstract

Background

Stereotactic body radiotherapy (SABR) plays an essential role in the curative treatment of early-stage lung cancer. Second primary malignancy (SPM) has become a significant concern in lung cancer management because of the increasing number of cancer survivors. However, whether SABR increases the risk of SPMs in early-stage lung cancer remains unknown.

Methods

Patients with T1–2N0M0 primary lung cancer who underwent either surgery or SABR between 2010 and 2015 were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database. A Kaplan–Meier analysis was conducted to compare the cumulative incidence of SPMs between patients who underwent radiotherapy and those who underwent surgery. Multivariable Cox regression analyses were performed to evaluate the risk of SPMs.

Results

The study included 22,809 2-year early-stage lung cancer survivors (radiotherapy, 3236; surgery, 19,573) and 17,048 5-year survivors (radiotherapy, 1501; surgery, 15,547). 196 second haematologic cancers and 1642 second solid malignancies were diagnosed. SABR was not associated with a higher overall risk of second haematologic cancers or second solid malignancies. However, after adjusting for independent influencing factors of SPMs, SABR was associated with a 38.5% higher cumulative incidence of secondary primary lung cancer. The risk was increased only when compared to the lobectomy group.

Conclusions

SABR for early-stage lung cancer was not associated with a higher overall risk of developing SPMs; however, it did increase the risk of second primary lung cancers when compared to the lobectomy group. Randomised controlled trials should be conducted in the future to validate our conclusions further.

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立体定向放疗与手术治疗早期肺癌后的第二原发性恶性肿瘤：一项基于美国人群的研究，2010-2015

背景立体定向放射治疗（SABR）在早期肺癌的治愈治疗中起着至关重要的作用。第二原发恶性肿瘤（SPM）已成为肺癌管理的一个重要问题，因为越来越多的癌症幸存者。然而，SABR是否会增加早期肺癌发生SPMs的风险尚不清楚。方法从监测、流行病学和最终结果（SEER）数据库中纳入2010年至2015年期间接受手术或SABR的T1-2N0M0原发性肺癌患者。Kaplan-Meier分析比较了放疗组和手术组SPMs的累积发病率。采用多变量Cox回归分析评估SPMs的风险。结果研究纳入22,809例2年早期肺癌幸存者（放疗，3236例；手术，19573例）和17,048例5年幸存者（放疗，1501例；手术，15,547例）。第二例血液癌196例，第二例实体恶性肿瘤1642例。SABR与第二种血液癌或第二种实体恶性肿瘤的较高总体风险无关。然而，在调整SPMs的独立影响因素后，SABR与继发性原发性肺癌累积发病率升高38.5%相关。只有与肺叶切除术组相比，风险才有所增加。结论ssabr与早期肺癌发生SPMs的总体风险无关；然而，与肺叶切除术组相比，它确实增加了患第二原发性肺癌的风险。未来应该进行随机对照试验来进一步验证我们的结论。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer treatment and research communications Medicine-Oncology

CiteScore

4.30

自引率

0.00%

发文量

148

审稿时长

56 days

期刊介绍： Cancer Treatment and Research Communications is an international peer-reviewed publication dedicated to providing comprehensive basic, translational, and clinical oncology research. The journal is devoted to articles on detection, diagnosis, prevention, policy, and treatment of cancer and provides a global forum for the nurturing and development of future generations of oncology scientists. Cancer Treatment and Research Communications publishes comprehensive reviews and original studies describing various aspects of basic through clinical research of all tumor types. The journal also accepts clinical studies in oncology, with an emphasis on prospective early phase clinical trials. Specific areas of interest include basic, translational, and clinical research and mechanistic approaches; cancer biology; molecular carcinogenesis; genetics and genomics; stem cell and developmental biology; immunology; molecular and cellular oncology; systems biology; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; cancer policy; and integration of various approaches. Our mission is to be the premier source of relevant information through promoting excellence in research and facilitating the timely translation of that science to health care and clinical practice.