Modelling second malignancy risks from low dose rate and high dose rate brachytherapy as monotherapy for localised prostate cancer

Murray, Louise; Mason, J.; Henry, Ann; Hoskin, Peter; Siebert, Frank‐André; Venselaar, J.L.M.; Bownes, Peter

doi:10.1016/j.radonc.2016.05.026

Cited by 9 publications

(6 citation statements)

References 31 publications

(41 reference statements)

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“…In contrast both LDR and HDR brachytherapy monotherapy result in low estimated risks of radiation-induced second malignancy. In particular excess absolute risks for LDR brachytherapy of 0.71 per 10,000 person-years (PY) and 0.84 per 10,000 PY respectively for rectal and bladder cancer have been estimated [61]. The corresponding rates for HDR brachytherapy were 0.74 and 1.62 per 10,000 PY respectively.…”

Section: Second Malignancy After Prostate Brachytherapymentioning

confidence: 99%

GEC-ESTRO ACROP prostate brachytherapy guidelines

Henry

Pieters

Siebert

et al. 2022

Radiotherapy and Oncology

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Section: Second Malignancy After Prostate Brachytherapymentioning

confidence: 99%

GEC-ESTRO ACROP prostate brachytherapy guidelines

Henry

Pieters

Siebert

et al. 2022

Radiotherapy and Oncology

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“…A possible explanation was that Aksnessaether et al (39) used high dose rate BT for prostate cancer treatment, which increased the aforementioned risk. High dose radiotherapy caused a higher risk of secondary bladder cancer than low dose radiotherapy (40). In the rst decade of this century, intensity-modulated radiotherapy (IMRT) became popular because it reduced the radiationrelated toxicity and meanwhile improve survival (41).…”

Section: Discussionmentioning

confidence: 99%

Whether pelvic radiotherapy increased the risk of secondary bladder cancer? A systematic review and meta-analysis

Dou¹,

Ren²,

Hu³

et al. 2020

Preprint

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Background The question whether pelvic radiotherapy increases the risk of secondary bladder cancer remains unclear. In this review, we aimed to demonstrate the relationship between exposure to radiation therapy for pelvic malignancies and subsequent second primary bladder cancer risk. Methods We systematically searched Medline, Embase and Web of Science for all associated studies concerning secondary bladder cancer risk and radiotherapy for primary pelvic cancers up to 15 th December 2019. We extracted related study characteristics and outcomes. Risk of bias was assessed by the Newcastle-Ottawa Scale. Outcomes were synthesized with random effect models and Manhtel-Haenszel weighting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational studies in Epidemiology (MOOSE) guidelines were used for reporting this systematic review and meta-analysis. We use GRADE system to assess the quality of main outcome. Results We identified 3958 references after literature searching and eventually 19 studies were selected for meta-analysis. Most studies were cohort studies with moderate risk of bias. Compared with patients treated without radiotherapy, our results showed an increased risk of secondary bladder cancer after radiotherapy for pelvic malignancies (RR 1.75,95% Confidence Interval [CI] 1.50-2.05) with moderate quality of evidence. Similar results were also found in organ-specific analysis of radiation therapy for testicular cancer(RR 2.25,95% CI 1.34-3.78),uterine cancer(RR 2.52,95%CI 1.12-5.67) and prostate cancer(RR 1.64 95%CI 1.39-1.93).Although a varied definitions of latency periods used in different studies, the results showed a consistently increased risk of bladder cancer in all analyzed latency periods, and lag time over 10 years ranked as the highest relative risk(RR 2.98,95%CI 1.88-4.71). When compared with no radiotherapy, EBRT and Any RT significantly increased the risk of second primary bladder cancer (RR 2.08,95%CI 1.67-2.61 and RR 1.77,95%CI 1.49-2.10), but not for BT group (RR 1.58,95%CI 0.98-2.55). Conclusion In conclusion, pelvic radiotherapy was associated with higher relative risk of secondary bladder cancer compared with those without radiotherapy. These findings may help outpatient counseling and early detection of secondary cancer after diagnosis and treatment of first primary cancer. Keywords: Secondary Bladder cancer, Pelvic malignancies, Radiotherapy, Meta-analysis

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“…However, some have even reported that the risk of developing a secondary cancer was lower with either low dose or high dose rate BT alone when compared to any EBRT technique 30. When further focused on the dose of BT, Murray et al40 revealed that PCa patients who received a low dose rate of BT resulted in lower BLCa risks than high dose rate. Taken together, it is likely to recommend younger and healthier patients who did not accept RP treatment for reasons to select BT.…”

Section: Discussionmentioning

confidence: 99%

High prevalence of secondary bladder cancer in men on radiotherapy for prostate cancer: evidence from a meta-analysis

Zhao¹,

Xie²,

Yang³

et al. 2019

CMAR

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ObjectiveTo assess whether radiotherapy (RT) for prostate cancer (PCa) was a risk factor for secondary bladder cancer (BLCa) through a meta-analysis.Materials and methodsThe MEDLINE, Embase, and the Cochrane Library were systematically searched for all studies investigating the risk of BLCa in patients with RT. The association between RT and risk of BLCa was summarized using hazard ratio with a 95%CI. The protocol for this meta-analysis is available from PROSPERO (CRD42018090075).ResultsOverall, 619,479 participants (age: 57–79 years) were included from 15 studies, 206,852 of whom were patients who received RT. Synthesis of results indicated that RT was significantly associated with an increased risk of BLCa compared with the risk in those who received radical prostatectomy or non-RT (overall HR=1.6, 95%CI: 1.33–1.92, P<0.001). The results were consistent when restricted to a 5-year lag period (HR=1.84, 95%CI: 1.26–2.69, P=0.002) and multivariable adjustment (HR=1.96, 95%CI: 1.47–2.62, P<0.001), but not for 10-year lag period (HR=1.93, 95%CI: 0.9– 4.16, P=0.093) and brachytherapy subgroup (HR=1.33, 95%CI: 0.87–2.05, P=0.188). The GRADE-profiler revealed that the rate of events of BLCa on average in the RT-patients and the non-RT control was 2,462/183,669 (1.3%) and 4,263/382,761(1.1%), respectively; the overall quality of the evidence was low.ConclusionPatients who received RT for PCa was associated with higher risks of developing secondary BLCa compared to those unexposed to RT, but the absolute effect was low.

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Modelling second malignancy risks from low dose rate and high dose rate brachytherapy as monotherapy for localised prostate cancer

Abstract: Article:Murray, L orcid.org/0000-0003-0658-6455, Mason, J, Henry, AM orcid.org/0000-0002-5379-6618 et al. (4 more

Cited by 9 publications

References 31 publications

GEC-ESTRO ACROP prostate brachytherapy guidelines

GEC-ESTRO ACROP prostate brachytherapy guidelines

Whether pelvic radiotherapy increased the risk of secondary bladder cancer? A systematic review and meta-analysis

High prevalence of secondary bladder cancer in men on radiotherapy for prostate cancer: evidence from a meta-analysis

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