1. Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer
- Author
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Mitchell Kamrava, Chenyang Wang, Patrick A. Kupelian, Allen M. Chen, Keisuke S. Iwamoto, Michael L. Steinberg, Christopher R. King, and Daniel A. Low
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Brachytherapy ,Urology ,Subgroup analysis ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Prostate cancer ,0302 clinical medicine ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,External beam radiotherapy ,Aged ,Proportional Hazards Models ,Prostatectomy ,Proportional hazards model ,business.industry ,Prostatic Neoplasms ,Neoplasms, Second Primary ,Hematology ,Middle Aged ,medicine.disease ,Surgery ,Haematopoiesis ,Oncology ,030220 oncology & carcinogenesis ,Cohort ,business - Abstract
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.
- Published
- 2017
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