Second primary cancer after radiotherapy for prostate cancer - A SEER analysis of brachytherapy versus external beam radiotherapy
Second primary cancer after radiotherapy for prostate cancer - A SEER analysis of brachytherapy versus external beam radiotherapy
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DOI：
10.1016/j.ijrobp.2007.12.043
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发表时间：
2008-09-01
影响因子：
7
通讯作者：
Hamilton, Kara
中科院分区：
文献类型：
--
作者：
Abdel-Wahab, May;Reis, Isildinha M.;Hamilton, Kara
目的：探讨第二原发癌（SPCs）和放疗性SPCs （RTSPCs）的发病率。患者和方法：比较1973-2002年监测、流行病学和最终结果数据库中四个治疗组局部区域前列腺癌SPCs和RTSPCs的发病率。两组均为无放疗（RT）、无手术（第一组）；外束放射治疗（EBRT）（第二组）；近距离放疗（第三组）；ERRT联合近距离治疗（第4组）。结果：EBRT组SPCs的年龄校正估计值高于近距离放疗组（2178 vs 1901 SPCs/100,000; p = 0.025）或无放疗、无手术组（1971 SPCs/100,000; p < 0.0001）。EBRT组晚期SPC（>= 5年）的年龄调整率（2425个SPC /10万）仅显著高于未接受RT、未接受手术组（1950个SPC /10万）（p < 0.0001）。经年龄、种族/民族和分级调整后的风险比，EBRT组与非RT、非手术组相比不变，为1.263 (p < 0.0001)，但近距离放疗组（5年为0.721至9年为1.200）和联合放疗组（5年为0.920至9年为1.317）随随访时间的长短而变化。无放疗组、无手术组与EBRT组的RTSPCs发生率仅有显著差异，增加162例/10万，SPC风险增加0.16% （p = 0.023）。两组间RTSPC发生率无显著差异。结论：两组间RTSPCs发病率无显著性差异。近距离放疗组总体SPCs的初始较小相对风险随着时间的推移而增加，直到曲线收敛，这表明该效应是由患者选择偏倚引起的。(C) 2008爱思唯尔公司
Purpose: To determine the incidence of second primary cancers (SPCs) and radiotherapy-induced SPCs (RTSPCs).Patients and Methods: The incidence of SPCs and RTSPCs was compared among four treatment groups with locoregional prostate adenocarcinoma in the 1973-2002 Surveillance, Epidemiology, and End Results database. These groups were no radiotherapy (RT), no surgery (Group 1); external beam RT (EBRT) (Group 2); brachytherapy (Group 3); and a combination of ERRT and brachytherapy (Group 4).Results: The age-adjusted estimates of SPCs were greater with EBRT than with brachytherapy (2,178 vs. 1,901 SPCs/100,000; p = 0.025) or with the no RT, no surgery group (1,971 SPCs/100,000; p < 0.0001). The age-adjusted rate of late SPC (>= 5 years) for EBRT (2,425 SPCs/100,000) was only significantly greater (p < 0.0001) than that for no RT, no surgery (1,950 SPCs/100,000). The hazard ratio adjusted for age, race/ethnicity, and grade was constant at 1.263 for EBRT compared with no RT, no surgery (p < 0.0001) but varied with the length of follow-up in both the brachytherapy (0.721 at 5 years to 1.200 at 9 years) and combination (0.920 at 5 years to 1.317 at 9 years) groups. The incidence of RTSPCs was only significantly different between the no RT, no surgery group and the EBRT group, with an increase of 162 cases/100,000 or a 0.16% increased SPC risk (p = 0.023). No significant differences in the incidence of RTSPC were seen between the RT groups.Conclusion: No significant differences were seen in the incidence of RTSPCs between the RT groups. The initial smaller relative risk of overall SPCs in the brachytherapy group increased with time until the curves converged, suggesting that the effect had resulted from patient selection bias. (C) 2008 Elsevier Inc.