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Uterine cancer radiation increased risk for bladder cancer
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The use of pelvic radiation therapy in the treatment of uterine cancer may be associated with the development of bladder cancer later in life, according to results of a retrospective study.
Researchers reviewed the records of 56,681 women from the SEER program’s Multiple Primary-Standardized Incidence Ratio (MP-SIR) database. All patients had received a diagnosis of uterine cancer between 1980 and 2005 and were managed with external beam radiation therapy (EBRT) with or without brachytherapy or without any radiation therapy.
For the purposes of this analysis, the researchers compared the following management approaches: no radiation therapy, EBRT only, EBRT with brachytherapy, and EBRT with or without brachytherapy. Follow-up for incident bladder cancer was conducted until Dec. 31, 2008. The researchers calculated the incidence of bladder cancer over time with counts, cumulative incidence functions (counts divided by numbers at risk at baseline) and person-time incidence rates (counts divided by person-years of observation).
During a mean follow-up of 15 years, the researchers found that bladder cancer was diagnosed in 146 (0.93%) of the 15,726 patients undergoing radiation therapy, and in 197 (0.48%) of the 40,955 patients whose treatment did not include radiation therapy, with an age-adjusted rate ratio of 2 (95% CI, 1.6-2.5). Bladder cancer was fatal in 39 (0.25%) of patients treated with radiation therapy and in 36 (0.09%) of those treated without radiation therapy.
Clinicians should be mindful of this potential risk when they use pelvic radiation therapy to treat patients with uterine cancer.
“Although the absolute risk of bladder cancer in post-[radiation therapy] uterine cancer patients may not be high enough to justify routine cystoscopic surveillance, physicians caring for post-[radiation therapy] uterine cancer patients should keep in mind the risk of bladder cancer in these patients is higher than in the general female population,” the investigators wrote. “Follow-up of these patients should include periodic discussions of common signs and symptoms of bladder cancer such as gross hematuria and new voiding symptoms, to assure patients know what to look for and what not to ignore.”
Disclosure: The researchers report no relevant financial disclosures.
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