TY - JOUR
T1 - Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer
AU - Wang, Chenyang
AU - King, Christopher R.
AU - Kamrava, Mitchell
AU - Iwamoto, Keisuke S.
AU - Chen, Allen M.
AU - Low, Daniel
AU - Kupelian, Patrick A.
AU - Steinberg, Michael L.
PY - 2016/10/30
Y1 - 2016/10/30
N2 - Background and purpose: Second malignancies (SM) after external beam radiotherapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa) are rare but serious sequelae. Materials and methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify men diagnosed with cT1-2N0M0 PCa between 1999 and 2005, who underwent EBRT, BT or radical prostatectomy (RP). Patients with time interval to second malignancy or follow-up shorter than five and two years were excluded for solid and hematopoietic SM analyses respectively. Risks for solid and hematopoietic SM were evaluated via the multivariate Fine and Gray proportional hazards model. Results: EBRT and BT resulted in similar increases in solid and hematopoietic SM compared to RP. In subgroup analysis stratified by treatment modality, only the EBRT cohort demonstrated significantly decreased solid and hematopoietic SM in years 2002-2005 compared to years 1999-2001, with adjusted-hazard ratios of 0.752 (p = 0.001) and 0.815 (p = 0.018) respectively. Conclusions: EBRT and BT resulted in statistically equivalent increase in both solid and hematopoietic SM compared to RP. EBRT in more recent years resulted in significantly decreased solid and hematopoietic SM, coinciding with increased utilization of IMRT.
AB - Background and purpose: Second malignancies (SM) after external beam radiotherapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa) are rare but serious sequelae. Materials and methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify men diagnosed with cT1-2N0M0 PCa between 1999 and 2005, who underwent EBRT, BT or radical prostatectomy (RP). Patients with time interval to second malignancy or follow-up shorter than five and two years were excluded for solid and hematopoietic SM analyses respectively. Risks for solid and hematopoietic SM were evaluated via the multivariate Fine and Gray proportional hazards model. Results: EBRT and BT resulted in similar increases in solid and hematopoietic SM compared to RP. In subgroup analysis stratified by treatment modality, only the EBRT cohort demonstrated significantly decreased solid and hematopoietic SM in years 2002-2005 compared to years 1999-2001, with adjusted-hazard ratios of 0.752 (p = 0.001) and 0.815 (p = 0.018) respectively. Conclusions: EBRT and BT resulted in statistically equivalent increase in both solid and hematopoietic SM compared to RP. EBRT in more recent years resulted in significantly decreased solid and hematopoietic SM, coinciding with increased utilization of IMRT.
KW - Brachytherapy
KW - External beam radiotherapy
KW - Prostate cancer
KW - Second malignancy
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U2 - 10.1016/j.radonc.2017.01.009
DO - 10.1016/j.radonc.2017.01.009
M3 - Article
AN - SCOPUS:85011596209
JO - Radiotherapy and Oncology
JF - Radiotherapy and Oncology
SN - 0167-8140
ER -