Second cancers in radically treated Norwegian prostate cancer patients
Second cancers in radically treated Norwegian prostate cancer patients
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DOI：
10.1080/0284186x.2019.1581377
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发表时间：
2019-03-14
期刊：
影响因子：
3.1
通讯作者：
Solberg, Arne
中科院分区：
文献类型：
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作者：
Aksnessaether, Bjorg Y.;Lund, Jo-Asmund;Solberg, Arne
简介：这项基于登记的队列研究的目的是估计根治性前列腺癌（PC）治疗后的第二次癌症（SC）风险，并评估风险是否受放疗的影响。材料和方法：我们从挪威癌症登记处收集了1997年至2014年所有首次诊断为PC的患者的数据。通过将我们的队列与标准男性人群进行比较，计算SC的标准化发病率比（SIR）。使用接受根治性直肠癌切除术（RP）治疗的患者作为参考，估计治疗组的亚分布风险比。结果：我们分析了24，592例根治性治疗的PC患者。外束放疗（EBRT）组和RP组的中位随访时间分别为7.75年和6.25年。在24，592例接受根治性治疗的患者中，SC的SIR与参考人群无关，EBRT后较高，SIR 1.12（1.07-1.17），RP后较低，SIR 0.93（0.87-0.99）。EBRT治疗的患者直肠癌和膀胱癌发生率较高，SIR分别为1.38（1.16-1.64）和1.49（1.31-1.69）。EBRT患者和RP后接受放射治疗的患者（RP后接受RT）发生任何SC的风险分别高出38%和27%。我们发现所有治疗组的膀胱癌风险均高于RP患者。只有EBRT治疗的患者显示直肠癌和肺癌的风险较高。讨论/结论：在我们的研究中，我们发现与一般人群相比，接受EBRT治疗的PC患者的SC发生率增加。以RP患者为参照，发现RP后接受EBRT和RT治疗的患者发生SC的风险增加。接受EBRT的患者发生直肠癌和膀胱癌的风险高于一般人群和接受根治性直肠癌切除术的患者。在讨论患者治疗和设计随访时，应考虑SC的风险。
Introduction: The aim of this registry-based cohort study was to estimate second cancer (SC) risk following radical prostate cancer (PC) treatment and evaluate if the risk was influenced by radiotherapy. Materials and methods: We collected data from the Cancer Registry of Norway on all patients with PC as first cancer diagnosis, from 1997 to 2014. Standardized incidence ratios (SIRs) for SC were calculated by comparing our cohort to the standard male population. Subdistribution hazard ratios were estimated in treatment groups, using patients treated with radical prostatectomy (RP) as reference. Results: We analyzed 24,592 radically treated PC patients. The median follow-up was 7.75 and 6.25 years in the external beam radiotherapy (EBRT) and RP-groups, respectively. SIR for SC was indifferent from the reference population in 24,592 radically treated patients, higher following EBRT, SIR 1.12 (1.07-1.17), and lower following RP, SIR 0.93 (0.87-0.99). EBRT treated patients had higher rectal and urinary bladder cancer incidences, SIR 1.38 (1.16-1.64) and 1.49 (1.31-1.69), respectively. The EBRT patients and the patients treated with radiation after RP (RT after RP) had 38 and 27% higher risk of any SC. We found higher risk of bladder cancer for all treatment groups as compared to RP patients. Only EBRT treated patients showed higher risk of rectal and lung cancer. Discussion/conclusions: In our study, we found that PC patients treated with EBRT had an increased incidence of SC compared to the general population. Patients treated with EBRT and RT after RP were found to have increased risk of SCs, using RP patients as reference. The risks of rectal and urinary bladder cancer in patients receiving EBRT were higher compared to both the general population and to patients treated with radical prostatectomy. The risk of SC should be taken into account when discussing treatment for patients and designing follow-up.