TY - JOUR
T1 - Analysis of second malignancies after modern radiotherapy versus prostatectomy for localized prostate cancer
AU - Huang, Jiayi
AU - Kestin, Larry L.
AU - Ye, Hong
AU - Wallace, Michelle
AU - Martinez, Alvaro A.
AU - Vicini, Frank A.
N1 - Funding Information:
The authors would like to thank Ms. Rachael Gjeltema and Ms. Beverly Robertson for support with data management. Special thanks to Dr. Fawn D. Vigneau and Dr. Ann G. Schwartz of the Metropolitan Detroit Cancer Surveillance System for providing the surgical SEER data. Their work was supported in part by the National Cancer Institute at the National Institutes of Health ( N01-PC-35145 ).
Funding Information:
This work was supported by the Beaumont Foundation.
PY - 2011/1
Y1 - 2011/1
N2 - Purpose: To clarify the risk of developing second primary cancers (SPCs) after radiotherapy (RT) versus prostatectomy for localized prostate cancer (PCa) in the modern era. Methods: The RT cohort consisted of 2120 patients matched on a 1:1 basis with surgical patients according to age and follow-up time. RT techniques consisted of conventional or two-dimensional RT (2DRT, 36%), three-dimensional conformal RT and/or intensity modulated RT (3DCRT/IMRT, 29%), brachytherapy (BT, 16%), and a combination of 2DRT and BT (BT boost, 19%). Results: The overall SPC risk was not significantly different between the matched-pair (HR 1.14, 95% CI 0.94-1.39), but the risk became significant >5 years or >10 years after RT (HR 1.86, 95% CI 1.36-2.55; HR 4.94, 95% CI 2.18-11.2, respectively). The most significant sites of increased risk were bladder, lymphoproliferative, and sarcoma. Of the different RT techniques, only 2DRT was associated with a significantly higher risk (HR 1.76, 95% CI 1.32-2.35), but not BT boost (HR 0.83, 95% CI 0.50-1.38), 3DCRT/IMRT (HR 0.81, 95% CI 0.55-1.21), or BT (HR 0.53, 95% CI 0.28-1.01). Conclusions: Radiation-related SPC risk varies depending on the RT technique and may be reduced by using BT, BT boost, or 3DCRT/IMRT.
AB - Purpose: To clarify the risk of developing second primary cancers (SPCs) after radiotherapy (RT) versus prostatectomy for localized prostate cancer (PCa) in the modern era. Methods: The RT cohort consisted of 2120 patients matched on a 1:1 basis with surgical patients according to age and follow-up time. RT techniques consisted of conventional or two-dimensional RT (2DRT, 36%), three-dimensional conformal RT and/or intensity modulated RT (3DCRT/IMRT, 29%), brachytherapy (BT, 16%), and a combination of 2DRT and BT (BT boost, 19%). Results: The overall SPC risk was not significantly different between the matched-pair (HR 1.14, 95% CI 0.94-1.39), but the risk became significant >5 years or >10 years after RT (HR 1.86, 95% CI 1.36-2.55; HR 4.94, 95% CI 2.18-11.2, respectively). The most significant sites of increased risk were bladder, lymphoproliferative, and sarcoma. Of the different RT techniques, only 2DRT was associated with a significantly higher risk (HR 1.76, 95% CI 1.32-2.35), but not BT boost (HR 0.83, 95% CI 0.50-1.38), 3DCRT/IMRT (HR 0.81, 95% CI 0.55-1.21), or BT (HR 0.53, 95% CI 0.28-1.01). Conclusions: Radiation-related SPC risk varies depending on the RT technique and may be reduced by using BT, BT boost, or 3DCRT/IMRT.
KW - Matched-pair analysis
KW - Prostate cancer
KW - Radiation therapy
KW - Second malignancies
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=78651376709&partnerID=8YFLogxK
U2 - 10.1016/j.radonc.2010.09.012
DO - 10.1016/j.radonc.2010.09.012
M3 - Article
C2 - 20951450
AN - SCOPUS:78651376709
SN - 0167-8140
VL - 98
SP - 81
EP - 86
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
IS - 1
ER -