Raadpleeg ook de literatuurlijst van niet-toxische ondersteuning bij prostaatkanker van arts-bioloog drs. Engelbert Valstar 

Als donateur kunt u ook korting krijgen bij verschillende bedrijven, waaronder bij Medpro voor o.a. prostasol  een veelgebruikt natuurlijk middel bij prostaatkanker als alternatief voor hormoontherapie

15 augustus 2022: Bron: JAMA

Bij patiënten met gelokaliseerde prostaatkanker was het risico op het ontwikkelen van een tweede primaire vorm van kanker laag, gemiddeld 3 procent; het risico daarop was echter wel hoger bij degenen die werden behandeld met radiotherapie - bestraling in vergelijking met patiënten die geen radiotherapie kregen maar bv alleen een operatie. Het verschil was 3,7 procent versus 2,5 procent voor de patiënten die geen radiotherapie hadden gehad.

Dit zijn de uitkomsten van een retrospectieve cohortstudie van 143.886 mannen met gelokaliseerde prostaatkanker (tumorstadium T1-T3). Bij deze mannen werden de incidentie en het risico op het ontwikkelen van een tweede primaire kanker beoordeeld 1 jaar na de diagnose van prostaatkanker.
Een tweede primaire kanker werd gediagnosticeerd bij 3% van alle deelnemende patiënten. Bij patiënten die alleen radiotherapie kregen (36,8% van de hele studiegroep), werd een tweede primaire kanker gediagnosticeerd bij 3,7% van de patiënten vergeleken met 2,5% van de patiënten in de niet-radiotherapiegroep. In multivariate analyses hadden patiënten die werden behandeld met radiotherapie een hoger risico op een tweede kankerdiagnose binnen 1 tot 5 jaar (HR 1,24; P < .001), en het risico nam in de loop van de tijd ook nog eens toe.

Het volledige studierapport is gratis in te zien of te downloaden dus beperk me tot deze inforamtie. Klik op de titel van het abstract voor het volledige studierapport:

Key Points

Question  Do patients with prostate cancer in the modern era have a higher incidence and risk of developing a second primary cancer after radiotherapy compared with nonradiotherapy treatments?

Findings  In this cohort study of 143 886 patients with localized prostate cancer, receipt of radiotherapy was associated with a small but statistically significant increase in the risk of developing a second primary cancer.

Meaning  This study’s findings suggest that it is important that shared decision-making among patients with prostate cancer includes discussion of late toxic effects, including the risk of developing a second primary cancer, and that the possibility of developing a second primary cancer after radiotherapy be considered during evaluation of symptoms among survivors.

Abstract

Importance  Shared decision-making is an important part of the treatment selection process among patients with prostate cancer. Updated information is needed regarding the long-term incidence and risk of second primary cancer after radiotherapy vs nonradiotherapy treatments, which may help to inform discussions of risks and benefits for men diagnosed with prostate cancer.

Objective  To assess the current incidence and risk of developing a second primary cancer after receipt of radiotherapy vs nonradiotherapy treatments for prostate cancer.

Design, Setting, and Participants  This retrospective cohort study used the Veterans Affairs Corporate Data Warehouse to identify 154 514 male veterans 18 years and older who had localized prostate cancer (tumor stages T1-T3) diagnosed between January 1, 2000, and December 31, 2015, and no cancer history. A total of 10 628 patients were excluded because of (1) incomplete treatment information for the year after diagnosis, (2) receipt of both radiotherapy and a surgical procedure in the year after diagnosis, (3) receipt of radiotherapy more than 1 year after diagnosis, (4) occurrence of second primary cancer or death within 1 year or less after diagnosis, (5) prostate-specific antigen value greater than 99 ng/mL within 6 months before diagnosis, or (6) no recorded Veterans Health Administration service after diagnosis. The remaining 143 886 patients included in the study had a median (IQR) follow-up of 9 (6-13) years. Data were analyzed from May 1, 2021, to May 22, 2022.

Main Outcomes and Measures  Diagnosis of a second primary cancer more than 1 year after prostate cancer diagnosis.

Results  Among 143 886 male veterans (median age, 65 [60-71] years) with localized prostate cancer, 750 (0.5%) were American Indian or Alaska Native, 389 (0.3%) were Asian, 37 796 (26.3%) were Black or African American, 933 (0.6%) were Native Hawaiian or other Pacific Islander, 91 091 (63.3%) were White, and 12 927 (9.0%) were of unknown race; 7299 patients (5.1%) were Hispanic or Latino, 128 796 (89.5%) were not Hispanic or Latino, and 7791 (5.4%) were of unknown ethnicity. A total of 52 886 patients (36.8%) received primary radiotherapy, and 91 000 (63.2%) did not. A second primary cancer more than 1 year after prostate cancer diagnosis was present in 4257 patients (3.0%), comprising 1955 patients (3.7%) in the radiotherapy cohort and 2302 patients (2.5%) in the nonradiotherapy cohort. In the multivariable analyses, patients in the radiotherapy cohort had a higher risk of second primary cancer compared with those in the nonradiotherapy cohort at years 1 to 5 after diagnosis (hazard ratio , 1.24; 95% CI, 1.13-1.37; P < .001), with higher adjusted HRs in the subsequent 15 years (years 5-10: 1.50 [95% CI, 1.36-1.65; P < .001]; years 10-15: 1.59 [95% CI, 1.37-1.84; P < .001]; years 15-20: 1.47 [95% CI, 1.08-2.01; P = .02).

Conclusions and Relevance  In this cohort study, patients with prostate cancer who received radiotherapy were more likely to develop a second primary cancer than patients who did not receive radiotherapy, with increased risk over time. Although the incidence and risk of developing a second primary cancer were low, it is important to discuss the risk with patients during shared decision-making about prostate cancer treatment options.

References
1.
National Comprehensive Cancer Network. Prostate cancer. National Comprehensive Cancer Network; 2022. Accessed May 17, 2022. https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf
2.
Hamdy  FC, Donovan  JL, Lane  JA,  et al. 10-Year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med. 2016;375(15):1415-1424. doi:10.1056/NEJMoa1606220
3.
Cahan  WG, Woodard  HQ, Higinbotham  NL, Stewart  FW, Coley  BL.  Sarcoma arising in irradiated bone: report of eleven cases.   Cancer. 1998;82(1):8-34. doi:10.1002/(SICI)1097-0142(19980101)82:1<8::AID-CNCR3>3.0.CO;2-WPubMedGoogle Scholar
4.
Singh  GK, Yadav  V, Singh  P, Bhowmik  KT.  Radiation-induced malignancies making radiotherapy a “two-edged sword”: a review of literature.   World J Oncol. 2017;8(1):1-6. doi:10.14740/wjon996wPubMedGoogle Scholar
5.
Neugut  AI, Ahsan  H, Robinson  E, Ennis  RD.  Bladder carcinoma and other second malignancies after radiotherapy for prostate carcinoma.   Cancer. 1997;79(8):1600-1604. doi:10.1002/(SICI)1097-0142(19970415)79:8<1600::AID-CNCR24>3.0.CO;2-0PubMedGoogle Scholar
6.
Kleinerman  RA, Boice  JD  Jr, Storm  HH,  et al.  Second primary cancer after treatment for cervical cancer: an international cancer registries study.   Cancer. 1995;76(3):442-452. doi:10.1002/1097-0142(19950801)76:3<442::AID-CNCR2820760315>3.0.CO;2-LPubMedGoogle Scholar
7.
Kaldor  JM, Day  NE, Kittelmann  B,  et al.  Bladder tumours following chemotherapy and radiotherapy for ovarian cancer: a case-control study.   Int J Cancer. 1995;63(1):1-6. doi:10.1002/ijc.2910630102PubMedGoogle Scholar
8.
Boice  JD  Jr, Day  NE, Andersen  A,  et al.  Second cancers following radiation treatment for cervical cancer. an international collaboration among cancer registries.   J Natl Cancer Inst. 1985;74(5):955-975. doi:10.1016/S0022-5347(17)47726-3PubMedGoogle Scholar
9.
Baxter  NN, Tepper  JE, Durham  SB, Rothenberger  DA, Virnig  BA.  Increased risk of rectal cancer after prostate radiation: a population-based study.   Gastroenterology. 2005;128(4):819-824. doi:10.1053/j.gastro.2004.12.038PubMedGoogle Scholar
10.
Kendal  WS, Eapen  L, Macrae  R, Malone  S, Nicholas  G.  Prostatic irradiation is not associated with any measurable increase in the risk of subsequent rectal cancer.   Int J Radiat Oncol Biol Phys. 2006;65(3):661-668. doi:10.1016/j.ijrobp.2005.11.013PubMedGoogle Scholar
11.
Movsas  B, Hanlon  AL, Pinover  W, Hanks  GE.  Is there an increased risk of second primaries following prostate irradiation?   Int J Radiat Oncol Biol Phys. 1998;41(2):251-255. doi:10.1016/S0360-3016(97)00570-1PubMedGoogle Scholar
12.
Voss EA, Makadia R, Matcho A, et al. Feasibility and utility of applications of the common data model to multiple, disparate observational health databases. J Am Med Inform Assoc. 2015;22(3):553-564. doi:10.1093/jamia/ocu023
13.
D’Amico  AV, Whittington  R, Malkowicz  SB,  et al.  Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer.   JAMA. 1998;280(11):969-974. doi:10.1001/jama.280.11.969
ArticlePubMedGoogle Scholar
14.
Daskivich  TJ, Thomas  IC, Luu  M,  et al.  External validation of the prostate cancer specific comorbidity index: a claims based tool for the prediction of life expectancy in men with prostate cancer.   J Urol. 2019;202(3):518-524. doi:10.1097/JU.0000000000000287PubMedGoogle Scholar
15.
McGinnis  KA, Brandt  CA, Skanderson  M,  et al.  Validating smoking data from the Veteran’s Affairs health factors dataset, an electronic data source.   Nicotine Tob Res. 2011;13(12):1233-1239. doi:10.1093/ntr/ntr206PubMedGoogle Scholar
16.
Murray  L, Henry  A, Hoskin  P, Siebert  FA, Venselaar  J; PROBATE Group of GEC ESTRO.  Second primary cancers after radiation for prostate cancer: a systematic review of the clinical data and impact of treatment technique.   Radiother Oncol. 2014;110(2):213-228. doi:10.1016/j.radonc.2013.12.012PubMedGoogle Scholar
17.
Pisansky  TM. External-beam radiotherapy for localized prostate cancer. New Engl J Med. 2006;355:1583-1591.
18.
Wang  R, Zeidan  AM, Yu  JB,  et al.  Myelodysplastic syndromes and acute myeloid leukemia after radiotherapy for prostate cancer: a population-based study.   Prostate. 2017;77(5):437-445. doi:10.1002/pros.23281PubMedGoogle Scholar
19.
Pawlish  KS, Schottenfeld  D, Severson  R, Montie  JE.  Risk of multiple primary cancers in prostate cancer patients in the Detroit metropolitan area: a retrospective cohort study.   Prostate. 1997;33(2):75-86. doi:10.1002/(SICI)1097-0045(19971001)33:2<75::AID-PROS1>3.0.CO;2-LPubMedGoogle Scholar
20.
Brenner  DJ, Curtis  RE, Hall  EJ, Ron  E.  Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery.   Cancer. 2000;88(2):398-406. doi:10.1002/(SICI)1097-0142(20000115)88:2<398::AID-CNCR22>3.0.CO;2-VPubMedGoogle Scholar
21.
Pickles  T, Phillips  N.  The risk of second malignancy in men with prostate cancer treated with or without radiation in British Columbia, 1984-2000.   Radiother Oncol. 2002;65(3):145-151. doi:10.1016/S0167-8140(02)00307-9PubMedGoogle Scholar
22.
Rapiti E, Fioretta G, Verkooijen HM, et al. Increased risk of colon cancer after external radiation therapy for prostate cancer. Int J Cancer. 2008;123(5):1141-1145. doi:10.1002/ijc.23601
23.
Bagshaw  MA, Cox  RS, Ray  GR.  Status of radiation treatment of prostate cancer at Stanford University.   NCI Monogr. 1988;(7):47-60.PubMedGoogle Scholar
24.
Zullig  LL, Jackson  GL, Dorn  RA,  et al.  Cancer incidence among patients of the U.S. Veterans Affairs health care system.   Mil Med. 2012;177(6):693-701. doi:10.7205/MILMED-D-11-00434PubMedGoogle Scholar
25.
Harrison  LB, Shasha  D, White  C, Ramdeen  B.  Radiotherapy-associated anemia: the scope of the problem.   Oncologist. 2000;5(suppl 2):1-7. doi:10.1634/theoncologist.5-suppl_2-1PubMedGoogle Scholar
26.
Harbron  RW, Pasqual  E.  Ionising radiation as a risk factor for lymphoma: a review.   J Radiol Prot. 2020;40(4):R151-R185. doi:10.1088/1361-6498/abbe37PubMedGoogle Scholar




Plaats een reactie ...

Reageer op "Patiënten met prostaatkanker die radiotherapie kregen, hadden een kleine kans maar wel meer kans om een tweede primaire kanker te ontwikkelen dan patiënten die geen radiotherapie kregen"


Gerelateerde artikelen