Abstract
BackgroundAs aging is the most significant risk factor for cancer development, long-term prostate cancer (PCa) survivors have an evident risk of developing subsequent primary cancers (SPCs). Radiotherapy itself is an additional risk factor for cancer development and the SPCs appearing beyond 5 years after radiotherapy in the original treatment field can be considered as radiation-induced subsequent primary cancers (RISPCs).MethodsDuring the years 1999-2008, 241 patients with localized PCa who underwent low dose-rate brachytherapy (LDR-BT) with I125 and were followed-up in Kuopio University Hospital, were included in this study. In this study the incidences and types of SPCs and RISPCs with a very long follow-up time after LDR-BT were evaluated.ResultsDuring the median follow-up time of 11.4 years, a total of 34 (14.1%) patients developed a metachronous SPC. The most abundant SPCs were lung and colorectal cancers, each diagnosed in six patients (16.7% out of all SPCs). The crude incidence rate of RISPC was 1.7% (n = 4). Half of the SPC cases (50%) were diagnosed during the latter half of the follow-up time as the risk to develop an SPC continued throughout the whole follow-up time with the actuarial 10-year SPC rate of 7.0%. The crude death rates due to metachronous out-of-field SPCs and RISPCs were 50 and 50%, respectively.ConclusionThe crude rate of SPC was in line with previously published data and the incidence of RISPC was very low. These results support the role of LDR-BT as a safe treatment option for patients with localized PCa.
Highlights
As aging is the most significant risk factor for cancer development, long-term prostate cancer (PCa) survivors have an evident risk of developing subsequent primary cancers (SPCs)
Radiotherapy (RT) is a risk factor for cancer development and SPCs appearing beyond 5 years after RT in the original treatment field can be considered as radiation-induced subsequent primary cancers (RISPCs) [2, 3]
With a median follow-up of 11.4 years in our real-life PCa patient cohort treated with low dose-rate brachytherapy (LDR-BT), the follow-up time is sufficient to report the incidences of SPCs and possible RISPCs
Summary
As aging is the most significant risk factor for cancer development, long-term prostate cancer (PCa) survivors have an evident risk of developing subsequent primary cancers (SPCs). Radiotherapy itself is an additional risk factor for cancer development and the SPCs appearing beyond 5 years after radiotherapy in the original treatment field can be considered as radiation-induced subsequent primary cancers (RISPCs). As aging is the most significant risk factor for cancer development, long-term PCa survivors have, per se, an evident risk of developing multiple subsequent primary cancers (SPCs). Radiotherapy (RT) is a risk factor for cancer development and SPCs appearing beyond 5 years after RT in the original treatment field can be considered as radiation-induced subsequent primary cancers (RISPCs) [2, 3]. The efficacy and the adverse event profile of the treatment approach, and the potential risk of SPC and RISPC may influence the selection of the treatment modality for PCa
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