Racial differences in the risk of second primary bladder cancer following radiation therapy among localized prostate cancer patients.
Racial differences in the risk of second primary bladder cancer following radiation therapy among localized prostate cancer patients.
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DOI：
10.1016/j.canep.2021.101967
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发表时间：
2021-08
影响因子：
2.6
通讯作者：
Wu XC
中科院分区：
文献类型：
--
作者：
Zhang L;Hsieh MC;Allison C;Devane M;Hicks C;Yu Q;Shi L;Wu J;Wu XC
探讨前列腺照射后种族特异性第二原发性膀胱癌（SPBC）的风险。路易斯安那州居民在1996-2013年被诊断患有局限性前列腺癌（PCa）并接受手术或放射治疗。患者随访至SPBC诊断、死亡或2018年12月。暴露变量为治疗类型（仅放疗vs.仅手术）。结果是从PCa诊断到SPBC诊断的时间，按种族分层。采用Fine和Gray的竞争风险模型，将死亡作为竞争事件，并调整社会人口统计学和肿瘤特征。我们使用5年和10年作为分析的滞后时间。共分析了26，277例PCa患者，中位随访时间为10.7年，包括18，598例白色患者和7，679例黑人患者。大约42.9%的白人和45.7%的黑人接受了辐射。SPBC在白色患者中分别占放射组和手术组的1.84%和0.90%，在黑人患者中分别占0.91%和0.58%。在白色患者中，与手术接受者相比，放射接受者的SPBC校正子分布风险比为1.80（95% CI：1.30-2.48）;如果仅限于外束放射治疗（EBRT），则为1.93（95% CI：1.36-2.74）。在黑人中，SPBC风险在放射治疗和手术治疗之间没有显著差异。与手术治疗的患者相比，白色照射PCa患者的SPBC风险几乎是其两倍。我们的研究结果强调需要加强监测白色前列腺癌幸存者接受放疗，特别是那些接受EBRT。
To investigate the race-specific second primary bladder cancer (SPBC) risk following prostatic irradiation. Louisiana residents who were diagnosed with localized prostate cancer (PCa) in 1996–2013 and received surgery or radiation were included. Patients were followed until SPBC diagnosis, death, or Dec. 2018. The exposure variable was type of treatment (radiation only vs. surgery only). The outcome was time from PCa diagnosis to SPBC diagnosis, stratified by race. Fine and Gray’s competing risk model was applied with death as a competing event and adjustment of sociodemographic and tumor characteristics. We used 5 years and 10 years as lag time in the analyses. A total of 26,277 PCa patients with a median follow-up of 10.7 years were analyzed, including 18,598 white and 7,679 black patients. About 42.9% of whites and 45.7% of blacks received radiation. SPBC counted for 1.84% in the radiation group and 0.90% in the surgery group among white patients and for 0.91% and 0.58%, respectively, among black patients. The adjusted subdistribution hazard ratio of SPBC was 1.80 (95% CI: 1.30–2.48) for radiation recipients compared to surgery recipients among white patients; 1.93 (95% CI: 1.36–2.74) if restricted to external beam radiation therapy (EBRT). The SPBC risk was not significantly different between irradiated and surgically treated among blacks. The SPBC risk is almost two-fold among white irradiated PCa patients compared to their counterparts treated surgically. Our findings highlight the need for enhanced surveillance for white PCa survivors receiving radiotherapy, especially those received EBRT.
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影响因子：
6.6
作者：
Boorjian, Stephen;Cowan, Janet E.;Kane, Christopher J.
通讯作者：
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