29 januari 2010: Bron: International Journal of Radiation Oncology

Wanneer prostaatkankerpatienten bestraald worden i.p.v. radicale operatie hebben zij een siognificant groter riscio op een secondaire vorm van kanker, zoals rectumkanker, longkanker en blaaskanker.  Dit blijkt uit een groot bevolkingsonderzoek bij 17.845 mannen met prostaatkanker verdeeld in bestralingsgroep en operatiegroep.

Na 5 jaar bleken uit de groep mannen die bestraald waren voor hun prostaatkanker significant meer blaaskanker, rectumkanker en longkanker voor te komen. Na tien jaar bleek alleen rectumkanker nog significant hoger te liggen. Hier het abstract van de studie uit International Journal of Radiation Oncology.

The Rate of Secondary Malignancies After Radical Prostatectomy Versus External Beam Radiation Therapy for Localized Prostate Cancer: A Population-Based Study on 17,845 Patients



Naeem Bhojani, M.D., Umberto Capitanio, M.D., Nazareno Suardi, M.D., Claudio Jeldres, M.D., Hendrik Isbarn, M.D.§, Shahrokh F. Shariat, M.D., Markus Graefen, M.D.§, Philippe Arjane, M.D., Alain Duclos, M.D., Jean-Baptiste Lattouf, M.D., Fred Saad, M.D., Luc Valiquette, M.D., Francesco Montorsi, M.D., Paul Perrotte, M.D., Pierre I. Karakiewicz, M.D.



Received 25 August 2008; received in revised form 6 February 2009; accepted 7 February 2009.


External-beam radiation therapy (EBRT) may predispose to secondary malignancies that include bladder cancer (BCa), rectal cancer (RCa), and lung cancer (LCa). We tested this hypothesis in a large French Canadian population-based cohort of prostate cancer patients.

Methods and Materials

Overall, 8,455 radical prostatectomy (RP) and 9,390 EBRT patients treated between 1983 and 2003 were assessed with Kaplan-Meier and Cox regression analyses. Three endpoints were examined: (1) diagnosis of secondary BCa, (2) LCa, or (3) RCa. Covariates included age, Charlson comorbidity index, and year of treatment.


In multivariable analyses that relied on incident cases diagnosed 60 months or later after RP or EBRT, the rates of BCa (hazard ratio , 1.4; p = 0.02), LCa (HR, 2.0; p = 0.004), and RCa (HR 2.1; p <0.001) were significantly higher in the EBRT group. When incident cases diagnosed 120 months or later after RP or EBRT were considered, only the rates of RCa (hazard ratio 2.2; p = 0.003) were significantly higher in the EBRT group. In both analyses, the absolute differences in incident rates ranged from 0.7 to 5.2% and the number needed to harm (where harm equaled secondary malignancies) ranged from 111 to 19, if EBRT was used instead of RP.


EBRT may predispose to clinically meaningfully higher rates of secondary BCa, LCa and RCa. These rates should be included in informed consent consideration

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