The Risk of Second Primary Cancers in Prostate Cancer Survivors Treated in the Modern Radiotherapy Era

Jahreiß, Marie-Christina; Aben, Katja K.H.; Hoogeman, M.; Dirkx, M.; Vries, Kim C. de; Incrocci, Luca; Heemsbergen, Wilma D.

doi:10.3389/fonc.2020.605119

Cited by 12 publications

(10 citation statements)

References 33 publications

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“…Therefore, AdvRT is at the expense of a larger volume of more distant tissues receiving low-to-moderate doses compared to more conformal RT (16,17). The results of this study as well as the theoretical concerns support the findings from the previously carried out single center study in which we observed that patients treated with IMRT had a significantly increased risk for non-pelvic cancers as opposed to those treated with 3D-CRT, especially in survivors aged <70 and active smokers at time of treatment (22).…”

Section: Discussionsupporting

confidence: 85%

“…However, no comparison was done with a 3D-CRT cohort. In a previous single-center study, where we investigated SPC risk after IMRT vs 3D-CRT, we observed no significant differences in overall pelvis SPC risks between the 2 techniques, with a trend for IMRT of lower bladder SPC risks and higher rectum SPC risks (22).…”

Section: Discussionmentioning

confidence: 55%

“…In our previous single-center study, we were able to investigate several potential confounders, such as the prescription of adjuvant HT. At sensitivity analysis, adjuvant HT demonstrated to be not affecting the results of the analysis (22). Hence, for this study we included both patients -with and without adjuvant HT prescription to the EBRT cohort.…”

Section: Discussionmentioning

confidence: 99%

“…Lastly, the AdvRT era is limited by its follow-up. We were unable to generate a thorough risk assessment on the effect AdvRT has on the development of a SPC beyond 10 years of follow-up (22,29,30).…”

Section: Discussionmentioning

confidence: 99%

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Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study

et al. 2021

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PurposeExternal Beam Radiotherapy (EBRT) techniques dramatically changed over the years. This may have affected the risk of radiation-induced second primary cancers (SPC), due to increased irradiated low dose volumes and scatter radiation. We investigated whether patterns of SPC after EBRT have changed over the years in prostate cancer (PCa) survivors.Materials and MethodsPCa survivors diagnosed between 1990-2014 were selected from the Netherlands Cancer Registry. Patients treated with EBRT were divided in three time periods, representing 2-dimensional Radiotherapy (RT), 3-dimensional conformal RT (3D-CRT), and the advanced RT (AdvRT) era. Standardized incidence ratios (SIR) and absolute excess risks (AER) were calculated to estimate relative and excess absolute SPC risks. Sub-hazard ratios (sHRs) were calculated to compare SPC rates between the EBRT and prostatectomy cohort. SPCs were categorized by subsite and anatomic region.ResultsPCa survivors who received EBRT had an increased risk of developing a solid SPC (SIR=1.08; 1.05-1.11), especially in patients aged <70 years (SIR=1.13; 1.09-1.16). Pelvic SPC risks were increased (SIR=1.28; 1.23-1.34), with no obvious differences between the three EBRT eras. Non-pelvic SPC were only significantly increased in the AdvRT era (SIR=1.08; 1.02-1.14), in particular for the 1-5 year follow-up period. Comparing the EBRT cohort to the prostatectomy cohort, again an increased pelvic SPC risk was found for all EBRT periods (sHRs= 1.61, 1.47-1.76). Increased non-pelvic SPC risks were present for all RT eras and highest for the AdvRT period (sHRs=1.17, 1.06-1.29).ConclusionSPC risk in patients with EBRT is increased and remained throughout the different EBRT eras. The risk of developing a SPC outside the pelvic area changed unfavorably in the AdvRT era. Prolonged follow-up is needed to confirm this observation. Whether this is associated with increased irradiated low-dose volumes and scatter, or other changes in clinical EBRT practice, is the subject of further research.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study

et al. 2021

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“…Modelling studies have expressed concerns that aspects of advanced EBRT are associated with an up to a 2-fold increased SPC risk [3,[7][8][9]. More recently, patient cohort studies have shown conflicting results on the risk of developing a SPC after advanced EBRT, with some studies observing increased SPC risks [10][11][12]. Other cohort studies, however, did not observe such increased risks [1,13].…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

Advances in radiotherapy and its impact on second primary cancer risk: A multi-center cohort study in prostate cancer patients

Jahreiß¹,

Hoogeman²,

Aben³

et al. 2023

Radiotherapy and Oncology

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La radiothérapie du cancer de la prostate augmente-t-elle le risque de seconds cancers ?

Boué-Raflé,

Briens,

Supiot

et al. 2024

Cancer/Radiothérapie

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The Risk of Second Primary Cancers in Prostate Cancer Survivors Treated in the Modern Radiotherapy Era

Cited by 12 publications

References 33 publications

Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study

Impact of Advanced Radiotherapy on Second Primary Cancer Risk in Prostate Cancer Survivors: A Nationwide Cohort Study

Advances in radiotherapy and its impact on second primary cancer risk: A multi-center cohort study in prostate cancer patients

La radiothérapie du cancer de la prostate augmente-t-elle le risque de seconds cancers ?

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