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No increased risk for second cancer after brachytherapy
Hinnen KA. J Clin Oncol. 2011;doi:10.1200/JCO.2011.35.0991.
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No difference in the rate of secondary primary cancers was found in a comparison of brachytherapy and prostatectomy for the treatment of prostate cancer.
Because brachytherapy exposes patients to ionizing radiation, it has been posited that its use as a treatment for prostate cancer may increase a patient’s risk for second primary cancer.
To explore this further, researchers examined a cohort of 1,888 patients with prostate cancer who were treated with brachytherapy (n=1187) or prostatectomy (n=701). The number of secondary primary cancers was retrieved from data in the Dutch Cancer Registry. The median age of patients was 64.7 years.
During follow-up, 223 second primary cancers occurred. The standardized incidence rate for developing any second primary cancer was 0.97 when compared with the general population. Overall, the researchers found no significant difference in the occurrence of second primary cancers by treatment type. When comparing brachytherapy with prostatectomy, the standardized incidence rate for developing any second primary malignancy was 0.94 for brachytherapy compared with 1.04 for prostatectomy.
Researchers did find that the risk for bladder cancer significantly increased among patients aged 60 years or younger who underwent brachytherapy (SIR=5.84; 95% CI, 2.14-12.71). In addition, the patients who underwent brachytherapy were at increased risk during the first 4 years of follow-up (SIR=2.14; 95% CI, 1.03-3.94).
“Because brachytherapy is becoming increasingly popular as an alternative to external beam radiation therapy and prostatectomy, knowledge of potential secondary primary cancer risk is important,” the researchers wrote. “Overall, this study does not show differences in second primary cancer incidence between patients with prostate cancer treated with prostatectomy or brachytherapy.”
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