Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer

Publication date: Available online 7 February 2017
Source:Radiotherapy and Oncology
Author(s): Chenyang Wang, Christopher R. King, Mitchell Kamrava, Keisuke S. Iwamoto, Allen M. Chen, Daniel Low, Patrick A. Kupelian, Michael L. Steinberg
Background and purposeSecond malignancies (SM) after external beam radiotherapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa) are rare but serious sequelae.Materials and methodsThe 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.ResultsEBRT 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.ConclusionsEBRT 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.



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