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Radiotherapy associated with greater risk of secondary malignancies in prostate cancer patients

Study shows overall hazard from external beam radiotherapy and brachytherapy remains low.

Study shows overall hazard from external beam radiotherapy and brachytherapy remains low

Compared to radical prostatectomy (RP), treatment for prostate cancer using external beam radiotherapy (EBRT) and brachytherapy (BT) is associated with a statistically significant and similar increase in risk for developing secondary malignancies. However, in absolute terms the overall increase in prevalence of solid tumours or blood-based cancer associated with this hazard remains low.

Using the Surveillance, Epidemiology, and End Results database, information from patients diagnosed with clinically localised prostate cancer (T1-2N0M0) between 1 January 1999 and 31 December 2005 who had undergone treatment with RP, EBRT and BT were reviewed, in this study.

Examination of the features for solid secondary-tumours suggested that bladder cancer was the most common secondary cancer of all three treatments. Increasing age was associated with an augmented risk, with an adjusted hazard

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Study shows overall hazard from external beam radiotherapy and brachytherapy remains low


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Compared to radical prostatectomy (RP), treatment for prostate cancer using external beam radiotherapy (EBRT) and brachytherapy (BT) is associated with a statistically significant and similar increase in risk for developing secondary malignancies. However, in absolute terms the overall increase in prevalence of solid tumours or blood-based cancer associated with this hazard remains low.

Using the Surveillance, Epidemiology, and End Results database, information from patients diagnosed with clinically localised prostate cancer (T1-2N0M0) between 1 January 1999 and 31 December 2005 who had undergone treatment with RP, EBRT and BT were reviewed, in this study.

Examination of the features for solid secondary-tumours suggested that bladder cancer was the most common secondary cancer of all three treatments. Increasing age was associated with an augmented risk, with an adjusted hazard ratio of 1.006/year.

Lymphoma was the most frequently occurring haematopoietic secondary cancer and, again, increasing age was associated with increasing risk of developing these complications. The decrease in the incidence of secondary malignancies associated with the use of EBRT, in the most recent year’s study data, is suggested to be due to changes in the means of delivering radiotherapy.

In this instance, the increased deployment of intensity-modulated radiotherapy permits greatly directed dose escalation while minimising the collateral damage to neighbouring tissues.


Wang C, King CR, Iwamoto KS et al (2017) Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer Radiotherapy and Oncology doi: 10.1016/j.radonc.2017.01.009

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