Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis
- PDF / 1,069,699 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 81 Downloads / 170 Views
RESEARCH
Open Access
Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis Nina-Sophie Hegemann1* , Anne Schlesinger-Raab2, Ute Ganswindt1, Claudia Hörl3, Stephanie E. Combs4,5, Dieter Hölzel2, Jürgen E. Gschwend6, Christian Stief7, Claus Belka1† and Jutta Engel2†
Abstract Background: To investigate the risk of second cancer and radiation induced second cancer following prostate cancer radiotherapy. Methods: We compared men with radiotherapy only with those treated with radical prostatectomy only and those with radiotherapy after radical prostatectomy. Cumulative incidences of second cancers were calculated. Cox analyses were performed to identify determinants influencing second cancer incidence. Results: Nineteen thousand five hundred thirty eight patients were analyzed. Age and median follow-up differed significantly with radiotherapy only patients having the highest median age (70.3 years) and radical prostatectomy only patients the longest median follow-up (10.2 years). Ten-year cumulative incidence of second cancer was 15.9%, 13.2% and 10.5% for patients with radiotherapy only, radiotherapy after radical prostatectomy and radical prostatectomy only (p 10 years in some publications even >15 years) [5, 6]. However, in real world settings the determination of SC risks—and especially RISC risks— after therapeutic exposures is strongly limited by several factors: Heterogeneous patient cohorts, small sample sizes, complex influence of confounders and lacking data. Nevertheless, in case of Hodgkin’s lymphoma and breast cancer several trials document an increase in SC and RISC [7–9]. The risk of lung cancer after breast RT is considerably low in non-smokers (Odds ratio 1), however an increase (25-fold) was detected in smokers [10]. Thus
© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Hegemann et al. Radiation Oncology (2017) 12:2
RISC in this setting is triggered mainly by synergisms with a strong confounding factor. In case of prostate cancer (PCa) patients being longterm cancer survivors [11] no clear picture emerges from all available data [12, 13]. Previous reports on the incidence of RISC using either Surveillance, Epidemiology, and End Results (SEER) or registry information provide conflicting results, whether after RT an increased risk of SC in PCa patients exists [14–25] or not [26–28]. With the help of the population-based Munich Cancer Registry (MCR) we attempted to gain further insight into SC risk after RT of
Data Loading...
