Secondary Cancers After Radiation Therapy for Primary Prostate or Rectal Cancer

Lee, Yen Chien; Hsieh, Chung Cheng; Li, Chung‐Yi; Chuang, Jen Pin; Lee, Jenq‐Chang

doi:10.1007/s00268-015-3324-x

Cited by 15 publications

(19 citation statements)

References 71 publications

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“…In current meta-analysis, the incidence of some cancers such as esophageal, stomach, liver, gallbladder, lung, thyroid and central nervous system compared to the normal population, was not only higher, but was also lower. According to some reports, the incidence of rectal cancer in patients with prostate malignancy is not significantly different from the general population [11].…”

Section: Discussionmentioning

confidence: 94%

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Risk of Secondary Malignancies in Patients with prostate cancer: A Systematic Review and Meta-analysis

Heydari

Rismantab

Shamshirian

et al. 2020

Preprint

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IMPORTANCE: Prostate cancer (PC) is the second most common cancer among males globally, however, the survival rate is favorable in most patients. In a small number of patients, who suffer from advanced or invasive cancer, various side effects such as secondary malignancies or treatment-related secondary malignancies (SMs) may be seen. OBJECTIVE: To systematically asses the risk of secondary malignancies in patients with prostate cancer. DATA SOURCES: We have searched for longitudinal studies through databases of Web of Science, Scopus and PubMed for all available data up to September 2019. STUDY SELECTION: Studies with longitudinal design on prostate cancer patients that declared the results in SIR or those that the SIR could be calculated were eligible. DATA EXTRACTION AND SYNTHESIS: The heterogeneity was evaluated using the I2 test. According to the results and in case of I2 ≥ 50%, the random effect model was used to combine the results. To identify the cause of heterogeneity in the studies, the analysis of sub-groups was performed based on the site of secondary malignancy, the treatment procedure, and duration of follow-up. Data were analyzed using STATA version 11. MAIN OUTCOMES AND MEASURES: Overall SIR and based on treatment of prostate cancer and duration of follow-up. RESULTS: Twenty-six studies involving more than 2223,704 patients with PC and more than 86034 cases of SMs were entered into this study. The meta-analysis showed that the risk of cancer after PC was 1.03 (95% CI 0.90 - 1.15) and the SIRs of some cancers such as the bladder 1.52 (1.06 - 1.99) and melanoma 1.32 (0.78 - 1.87) were higher than expected. While, malignancies such as rectum 0.92 (0.85 - 1.00), lung 0.85 (0.74 - 0.96) and liver 0.76 (0.54 - 0.98) showed lower incidence in compare to general population. CONCLUSIONS AND RELEVANCE: The overall risk of SMs in patients with prostate cancer is not significantly different from general population, and even in patients undergoing prostatectomy or brachytherapy, the risk is lower. But the incidence of some cancers such as melanoma, bladder, and urinary tract appears to be higher than the public in all types of treatment approaches.

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Section: Discussionmentioning

confidence: 94%

“…In a study, Lee et al assessed the risk of radiation therapy-induced secondary malignancies in patients with prostate and rectal cancer [11]. Also, in a meta-analysis study, Jin et al examined the incidence of secondary malignancies in patients with prostate cancer following radiotherapy [12].…”

Section: Introductionmentioning

confidence: 99%

Risk of Secondary Malignancies in Patients with prostate cancer: A Systematic Review and Meta-analysis

Heydari

Rismantab

Shamshirian

et al. 2020

Preprint

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“…Some studies evaluated also the impact of RT technique on the incidence of second tumors. In particular, three meta-analyses uniformly recorded a higher incidence of second rectal tumors after EBRT but not after brachytherapy [4,5,26]. In another study no differences were observed in terms of overall incidence of second tumors between 2D-conventional and 3D-CRT but only an advantage in patients undergoing 3D-CRT in terms of second rectal tumors.…”

Section: Discussionmentioning

confidence: 96%

“…In the past, even if the results are somehow contradictory [26] and the incidence of second tumors could also be attributed to age and lifestyles [6], several analyses showed an increased risk for second tumors after EBRT of PCa [3][4][5]24]. Probably these data should be considered with caution.…”

Section: Discussionmentioning

confidence: 99%

Radiotherapy of prostate cancer: impact of treatment characteristics on the incidence of second tumors

et al. 2020

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Background: It has been hypothesized that radiotherapy (RT) techniques delivering radiations to larger volumes (IMRT, VMAT) are potentially associated with a higher risk of second primary tumors. The aim of this study was to analyse the impact of RT technique (3D-CRT vs IMRT/VMAT) on the incidence of second tumors in prostate cancer (PCa) patients. Methods: A retrospective study on 2526 previously irradiated PCa patients was performed. Patients were treated with 3D-CRT (21.3%), IMRT (68.1%), or VMAT (10.6%). Second tumors incidence was analysed in 3 categories: pelvic, pelvic and abdominal, and "any site". The correlation with RT technique was analysed using log-rank test and Cox's proportional hazard method. Results: With a median follow-up of 72 months (range: 9-185), 92 (3.6%) cases of second tumors were recorded with 48 months (range: 9-152) median interval from RT. Actuarial 10-year second tumor free survival (STFS) was 87.3%. Ten-year STFS in patients treated with 3D-CRT and IMRT/VMAT was 85.8 and 84.5%, respectively (p: .627). A significantly higher 10-year cumulative incidence of second tumors in the pelvis was registered in patients treated with IMRT/VMAT compared to 3D-CRT (10.7% vs 6.0%; p: .033). The lower incidence of second pelvic cancers in patients treated with 3D-CRT was confirmed at multivariable analysis (HR: 2.42, 95%CI: 1.07-5.47, p: .034). Conclusions: The incidence of second pelvic tumors after RT of PCa showed a significant correlation with treatment technique. Further analyses in larger series with prolonged follow-up are needed to confirm these results.

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“…Although there have been many studies of secondary cancer risk after EBRT, fewer have analyzed secondary cancer risk after brachytherapy (15‐19) . For example, although cervical cancer is usually treated with high‐dose‐rate (HDR) brachytherapy, few studies have analyzed secondary cancer risk due to HDR brachytherapy in patients with cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Secondary cancer‐incidence risk estimates for external radiotherapy and high‐dose‐rate brachytherapy in cervical cancer: phantom study

Lee

Ahn

Kim

et al. 2016

J Applied Clin Med Phys

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This study was designed to estimate radiation‐induced secondary cancer risks from high‐dose‐rate (HDR) brachytherapy and external radiotherapy for patients with cervical cancer based on measurements of doses absorbed by various organs. Organ doses from HDR brachytherapy and external radiotherapy were measured using glass rod dosimeters. Doses to out‐of‐field organs were measured at various locations inside an anthropomorphic phantom. Brachytherapy‐associated organ doses were measured using a specialized phantom that enabled applicator insertion, with the pelvis portion of the existing anthropomorphic phantom replaced by this new phantom. Measured organ doses were used to calculate secondary cancer risk based on Biological Effects of Ionizing Radiation (BEIR) VII models. In both treatment modalities, organ doses per prescribed dose (PD) mostly depended on the distance between organs. The locations showing the highest and lowest doses were the right kidney (external radiotherapy: 215.2 mGy; brachytherapy: 655.17 mGy) and the brain (external radiotherapy: 15.82 mGy; brachytherapy: 2.49 mGy), respectively. Organ doses to nearby regions were higher for brachytherapy than for external beam therapy, whereas organ doses to distant regions were higher for external beam therapy. Organ doses to distant treatment regions in external radiotherapy were due primarily to out‐of‐field radiation resulting from scattering and leakage in the gantry head. For brachytherapy, the highest estimated lifetime attributable risk per 100,000 population was to the stomach (88.6), whereas the lowest risks were to the brain (0.4) and eye (0.4); for external radiotherapy, the highest and lowest risks were to the thyroid (305.1) and brain (2.4). These results may help provide a database on the impact of radiotherapy‐induced secondary cancer incidence during cervical cancer treatment, as well as suggest further research on strategies to counteract the risks of radiotherapy‐associated secondary malignancies.PACS number(s): 87.52.‐g, 87.52.Px, 87.53.Dq, 87.53.Jw

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Secondary Cancers After Radiation Therapy for Primary Prostate or Rectal Cancer

Cited by 15 publications

References 71 publications

Risk of Secondary Malignancies in Patients with prostate cancer: A Systematic Review and Meta-analysis

Risk of Secondary Malignancies in Patients with prostate cancer: A Systematic Review and Meta-analysis

Radiotherapy of prostate cancer: impact of treatment characteristics on the incidence of second tumors

Secondary cancer‐incidence risk estimates for external radiotherapy and high‐dose‐rate brachytherapy in cervical cancer: phantom study

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