Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Radiation Oncology
Published in: Radiation Oncology 1/2017

Open Access 01-12-2017 | Research

Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis

Authors: Nina-Sophie Hegemann, Anne Schlesinger-Raab, Ute Ganswindt, Claudia Hörl, Stephanie E. Combs, Dieter Hölzel, Jürgen E. Gschwend, Christian Stief, Claus Belka, Jutta Engel

Published in: Radiation Oncology | Issue 1/2017

Login to get access

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 <0.0001). Increasing age and belonging to the radiotherapy only group were associated with a higher risk of second cancer—no significant increase was seen in radiotherapy after radical prostatectomy patients. A significantly higher rate of smoking related malignancies, like lung, bladder and non-melanoma skin cancer, was seen in radiotherapy only patients.

Conclusions

No clear increase in radiation induced second cancer was found in patients after radiotherapy for prostate cancer. Whereas the rate of second cancer was increased in radiotherapy only patients, no such increase was seen in patients with radiotherapy after radical prostatectomy. The increase of second cancer following radiotherapy only is highly likely to reflect advanced age and lifestyle habits and comorbidities.
Literature
1.
Murray L, Henry A, Hoskin P, Siebert F-A, Venselaar J. Second primary cancers after radiation for prostate cancer: A systematic review of the clinical data and impact of treatment technique. Radiother Oncol. 2014;110:213–28.CrossRefPubMedPubMedCentral
2.
Murray L, Henry A, Hoskin P, Siebert FA, Venselaar J. Second primary cancers after radiation for prostate cancer: a review of data from planning studies. Radiat Oncol. 2013;8:172.CrossRefPubMedPubMedCentral
3.
Moiseenko V, Khvostunov IK, Hattangadi-Gluth JA, Muren LP, Lloyd DC. Biological dosimetry to assess risks of health effects in victims of radiation accidents: Thirty years after Chernobyl. Radiother Oncol. 2016;119:1–4.CrossRefPubMed
4.
Zhang R, Mirkovic D, Newhauser WD. Visualization of risk of radiogenic second cancer in the organs and tissues of the human body. Radiat Oncol. 2015;10:107.CrossRefPubMedPubMedCentral
5.
Thompson DE, Mabuchi K, Ron E, Soda M, Tokunaga M, Ochikubo S, et al. Cancer incidence in atomic bomb survivors. Part II: Solid tumors, 1958–1987. Radiat Res. 1994;137:S17–67.CrossRefPubMed
6.
Li CI, Nishi N, McDougall JA, Semmens EO, Sugiyama H, Soda M, et al. Relationship between radiation exposure and risk of second primary cancers among atomic bomb survivors. Cancer Res. 2010;70:7187–98.CrossRefPubMedPubMedCentral
7.
Grantzau T, Overgaard J. Risk of second non-breast cancer after radiotherapy for breast cancer: a systematic review and meta-analysis of 762,468 patients. Radiother Oncol. 2015;114:56–65.CrossRefPubMed
8.
Schaapveld M, Aleman BMP, van Eggermond AM, Janus CPM, Krol ADG, van der Maazen RWM, et al. Second Cancer Risk Up to 40 Years after Treatment for Hodgkin’s Lymphoma. N Engl J Med. 2015;373:2499–511.CrossRefPubMed
9.
Finke I, Scholz-Kreisel P, Hennewig U, Blettner M, Spix C. Radiotherapy and subsequent thyroid cancer in German childhood cancer survivors: a nested case–control study. Radiat Oncol. 2015;10:219.CrossRefPubMedPubMedCentral
10.
Grantzau T, Thomsen MS, Væth M, Overgaard J. Risk of second primary lung cancer in women after radiotherapy for breast cancer. Radiother Oncol. 2014;111:366–73.CrossRefPubMed
11.
12.
Müller AC, Ganswindt U, Bamberg M, Belka C. Risk of second malignancies after prostate irradiation? Strahlenther Onkol. 2007;183:605–9.CrossRefPubMed
13.
Wallis CJ, Mahar AL, Choo R, Herschorn S, Kodama RT, Shah PS, et al. Second malignancies after radiotherapy for prostate cancer: systematic review and meta-analysis. BMJ. 2016;352:i851.CrossRefPubMedPubMedCentral
14.
Abdel-Wahab M, Reis IM, Wu J, Duncan R. Second primary cancer risk of radiation therapy after radical prostatectomy for prostate cancer: an analysis of SEER data. Urology. 2009;74:866–71.CrossRefPubMed
15.
Davis EJ, Beebe-Dimmer JL, Yee CL, Cooney KA. Risk of second primary tumors in men diagnosed with prostate cancer: A population-based cohort study. Cancer. 2014;120:2735–41.CrossRefPubMedPubMedCentral
16.
Brenner DJ, Curtis RE, Hall EJ, Ron E. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer. 2000;88:398–406.CrossRefPubMed
17.
Huang J, Kestin LL, Ye H, Wallace M, Martinez AA, Vicini FA. Analysis of second malignancies after modern radiotherapy versus prostatectomy for localized prostate cancer. Radiother Oncol. 2011;98:81–6.CrossRefPubMed
18.
Baxter NN, Tepper JE, Durham SB, Rothenberger DA, Virnig BA. Increased risk of rectal cancer after prostate radiation: A population-based study. Gastroenterology. 2005;128:819–24.CrossRefPubMed
19.
Nieder AM, Porter MP, Soloway MS. Radiation therapy for prostate cancer increases subsequent risk of bladder and rectal cancer: a population based cohort study. J Urol. 2008;180:2005–9.CrossRefPubMed
20.
Singh AK, Mashtare TL, McCloskey SA, Seixas-Mikelus SA, Kim HL, May KS. Increasing age and treatment modality are predictors for subsequent diagnosis of bladder cancer following prostate cancer diagnosis. Int J Radiat Oncol Biol Phys. 2010;78:1086–94.CrossRefPubMed
21.
Zelefsky MJ, Housman DM, Pei X, Alicikus Z, Magsanoc JM, Dauer LT, et al. Incidence of secondary cancer development after high-dose intensity-modulated radiotherapy and image-guided brachytherapy for the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys. 2012;83:953–9.CrossRefPubMed
22.
Pickles T, Phillips N. The risk of second malignancy in men with prostate cancer treated with or without radiation in British Columbia, 1984–2000. Radiother Oncol. 2002;65:145–51.CrossRefPubMed
23.
Bhojani N, Capitanio U, Suardi N, Jeldres C, Isbarn H, Shariat SF, et al. The rate of secondary malignancies after radical prostatectomy versus external beam radiation therapy for localized prostate cancer: A population-based study on 17,845 patients. Int J Radiat Oncol Biol Phys. 2010;76:342–8.CrossRefPubMed
24.
Berrington de Gonzalez A, Curtis RE, Kry SF, Gilbert E, Lamart S, Berg CD, et al. Proportion of second cancers attributable to radiotherapy treatment in adults: a cohort study in the US SEER cancer registries. Lancet Oncol. 2011;12:353–60.CrossRefPubMed
25.
Abdel-Wahab M, Reis IM, Hamilton K. Second primary cancer after radiotherapy for prostate cancer--a seer analysis of brachytherapy versus external beam radiotherapy. Int J Radiat Oncol Biol Phys. 2008;72:58–68.CrossRefPubMed
26.
Kendal WS, Eapen L, Macrae R, Malone S, Nicholas G. Prostatic irradiation is not associated with any measurable increase in the risk of subsequent rectal cancer. Int J Radiat Oncol Biol Phys. 2006;65:661–8.CrossRefPubMed
27.
Zelefsky MJ, Pei X, Teslova T, Kuk D, Magsanoc JM, Kollmeier M, et al. Secondary cancers after intensity-modulated radiotherapy, brachytherapy and radical prostatectomy for the treatment of prostate cancer: incidence and cause-specific survival outcomes according to the initial treatment intervention. BJU Int. 2012;110:1696–701.CrossRefPubMed
28.
Chrouser K, Leibovich B, Bergstralh E, Zincke H, Blute M. Bladder cancer risk following primary and adjuvant external beam radiation for prostate cancer. J Urol. 2008;179:S7–S11.CrossRefPubMed
29.
30.
Kutikov A, Cooperberg MR, Paciorek AT, Uzzo RG, Carroll PR, Boorjian SA. Evaluating prostate cancer mortality and competing risks of death in patients with localized prostate cancer using a comprehensive nomogram. Prostate Cancer. 2012;15:374–9.CrossRef
31.
Hellawell GO, Dearden JC. What are the risks of second cancer formation after radiotherapy to the prostate? BJU Int. 2007;99:698.CrossRefPubMed
32.
Kendal W, Eapen L, Nicholas G. Second primary cancers after prostatic irradiation: Ensuring an appropriate analysis. Cancer. 2007;109:164.CrossRefPubMed
33.
Wiltink LM, Nout RA, Fiocco M, Meershoek-Klein KE, Jürgenliemk-Schulz IM, Jobsen JJ, et al. No Increased Risk of Second Cancer After Radiotherapy in Patients Treated for Rectal or Endometrial Cancer in the Randomized TME, PORTEC-1, and PORTEC-2 Trials. J Clin Oncol. 2014;33:1640–6.CrossRefPubMed
34.
Hamilton SN, Tyldesley S, Hamm J, Jiang WN, Keyes M, Pickles T, et al. Incidence of Second Malignancies in Prostate Cancer Patients Treated With Low-Dose-Rate Brachytherapy and Radical Prostatectomy. Int J Radiat Oncol Biol Phys. 2014;90:934–41.CrossRefPubMed
35.
Donin N, Filson C, Drakaki A, Tan HJ, Castillo A, Kwan L, et al. Risk of second primary malignancies among cancer survivors in the United States, 1992 through 2008. Cancer. 2016;122:3075–86.CrossRefPubMed
36.
Merino T, San Francisco IF, Rojas PA, Bettoli P, Zúñiga A, Besa P. Intensity-modulated radiotherapy versus radical prostatectomy in patients with localized prostate cancer: long-term follow-up. BMC Cancer. 2013;13:530.CrossRefPubMedPubMedCentral
37.
Hyde C. Rate of Secondary Malignancies After Radical Prostatectomy Versus External Beam Radiation Therapy for Localized Prostate Cancer (Int J Radiat Oncol Biol Phys. 2010;76:342–348). Int J Radiat Oncol Biol Phys. 2010;77:607.CrossRef
38.
Kim DW, Chung K, Chung WK, Bae SH, Shin DO, Hong S, et al. Risk of secondary cancers from scattered radiation during intensity-modulated radiotherapies for hepatocellular carcinoma. Radiat Oncol. 2014;9:109.CrossRefPubMedPubMedCentral
39.
Leonardi-Bee J, Ellison T, Bath-Hextall F. Smoking and the risk of nonmelanoma skin cancer: systematic review and meta-analysis. Arch Dermatol. 2012;148:939–46.CrossRefPubMed
40.
Moon K, Stukenborg GJ, Keim J, Theodorescu D. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006;107:991–8.CrossRefPubMed
Metadata
Title
Risk of second cancer following radiotherapy for prostate cancer: a population-based analysis
Authors
Nina-Sophie Hegemann
Anne Schlesinger-Raab
Ute Ganswindt
Claudia Hörl
Stephanie E. Combs
Dieter Hölzel
Jürgen E. Gschwend
Christian Stief
Claus Belka
Jutta Engel
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2017
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/s13014-016-0738-z

Other articles of this Issue 1/2017

Radiation Oncology 1/2017 Go to the issue

Research

Long-term patient reported outcomes following radiation therapy for oropharyngeal cancer: cross-sectional assessment of a prospective symptom survey in patients ≥65 years old

Research

Does age really matter? Radiotherapy in elderly patients with glioblastoma, the Munich experience

Research

Prostate cancer treated with brachytherapy; an exploratory study of dose-dependent biomarkers and quality of life

Research

Analysis of the relationship between prescribed dose and dosimetric advantage of real-time intraoperatively built custom-linked seeds in iodine-125 prostate brachytherapy

Research

Helical tomotherapy of spinal chordomas: French Multicentric, retrospective study of a cohort of 30 cases

Research

RapidPlan head and neck model: the objectives and possible clinical benefit