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de Angelis M, Siech C, Di Bello F, Peñaranda NR, Goyal JA, Tian Z, Longo N, Chun FKH, Puliatti S, Saad F, Shariat SF, Longoni M, Gandaglia G, Moschini M, Montorsi F, Briganti A, Karakiewicz PI. Incidence, Characteristics and Survival Rates of Bladder Cancer after Rectosigmoid Cancer Radiation. Cancers (Basel) 2024; 16:2404. [PMID: 39001466 PMCID: PMC11240771 DOI: 10.3390/cancers16132404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 06/27/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND Historical external beam radiation therapy (EBRT) for rectosigmoid cancer (RCa) predisposed patients to an increased risk of secondary bladder cancer (BCa). However, no contemporary radiotherapy studies are available. We addressed this knowledge gap. MATERIALS AND METHODS Within the Surveillance, Epidemiology, and End Results database (2000-2020), we identified non-metastatic RCa patients who either underwent radiotherapy (EBRT+) or did not (EBRT-). Cumulative incidence plots and multivariable competing risk regression models (CRR) were fitted to address rates of BCa after RCa. In the subgroup of BCa patients, the same methodology addressed BCa-specific mortality (BCSM) according to EBRT exposure status. RESULTS Of the 188,658 non-metastatic RCa patients, 54,562 (29%) were EBRT+ vs. 134,096 (73%) who were EBRT-. In the cumulative incidence plots, the ten-year BCa rates were 0.7% in EBRT+ vs. 0.7% in EBRT- patients (p = 0.8). In the CRR, EBRT+ status was unrelated to BCa rates (multivariable HR: 1.1, p = 0.8). In the subgroup of 1416 patients with BCa after RCa, 443 (31%) were EBRT+ vs. 973 (69%) who were EBRT-. In the cumulative incidence plots, the ten-year BCSM rates were 10.6% in EBRT+ vs. 12.1% in EBRT- patients (p = 0.7). In the CRR, EBRT+ status was unrelated to subsequent BCSM rates (multivariable HR: 0.9, p = 0.9). CONCLUSION Although historical EBRT for RCa predisposed patients to higher BCa rates, contemporary EBRT for RCa is not associated with increased subsequent BCa risk. Moreover, in patients with BCa after RCa, exposure to EBRT does not affect BCSM.
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Affiliation(s)
- Mario de Angelis
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Carolin Siech
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
- Department of Urology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany;
| | - Francesco Di Bello
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy;
| | - Natali Rodriguez Peñaranda
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
- Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Jordan A. Goyal
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
| | - Zhe Tian
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
| | - Nicola Longo
- Department of Neurosciences, Science of Reproduction and Odontostomatology, University of Naples Federico II, 80131 Naples, Italy;
| | - Felix K. H. Chun
- Department of Urology, University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany;
| | - Stefano Puliatti
- Department of Urology, Ospedale Policlinico e Nuovo Ospedale Civile S. Agostino Estense Modena, University of Modena and Reggio Emilia, 41121 Modena, Italy;
| | - Fred Saad
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
| | - Shahrokh F. Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, 1090 Vienna, Austria;
- Department of Urology, Weill Cornell Medical College, New York, NY 10065, USA
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Hourani Center of Applied Scientific Research, Al-Ahliyya Amman University, Amman 19328, Jordan
| | - Mattia Longoni
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Giorgio Gandaglia
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Marco Moschini
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Alberto Briganti
- Division of Experimental Oncology, Unit of Urology, URI, IRCCS Ospedale San Raffaele, 20132 Milan, Italy; (M.L.); (G.G.); (M.M.); (F.M.); (A.B.)
- Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC H2X 3E4, Canada; (M.d.A.); (C.S.); (F.D.B.); (N.R.P.); (J.A.G.); (Z.T.); (F.S.)
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Chen K, Liu C, Li X, Chen T, Liu S, Xiong F, Zhang Z. Risk and prognosis of secondary lung cancer after radiation therapy for thoracic malignancies. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13760. [PMID: 38725324 PMCID: PMC11082536 DOI: 10.1111/crj.13760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 03/09/2024] [Accepted: 04/12/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVE Radiation therapy (RT) may increase the risk of second cancer. This study aimed to determine the association between exposure to radiotherapy for the treatment of thoracic cancer (TC) and subsequent secondary lung cancer (SLC). MATERIALS AND METHODS The Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for TC. Univariate Cox regression analyses and multiple primary standardized incidence ratios (SIRs) were used to assess the risk of SLC. Subgroup analyses of patients stratified by latency time since TC diagnosis, age at TC diagnosis, and calendar year of TC diagnosis stage were also performed. Overall survival and SLC-related death were compared among the RT and no radiation therapy (NRT) groups by using Kaplan-Meier analysis and competitive risk analysis. RESULTS In a total of 329 129 observations, 147 847 of whom had been treated with RT. And 6799 patients developed SLC. Receiving radiotherapy was related to a higher risk of developing SLC for TC patients (adjusted HR, 1.25; 95% CI, 1.19-1.32; P < 0.001). The cumulative incidence of developing SLC in TC patients with RT (3.8%) was higher than the cumulative incidence (2.9%) in TC patients with NRT(P). The incidence risk of SLC in TC patients who received radiotherapy was significantly higher than the US general population (SIR, 1.19; 95% CI, 1.14-1.23; P < 0.050). CONCLUSIONS Radiotherapy for TC was associated with higher risks of developing SLC compared with patients unexposed to radiotherapy.
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Affiliation(s)
- Kang Chen
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Chong Liu
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Xueman Li
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Tianyou Chen
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Shan Liu
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Fei Xiong
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
| | - Zhou Zhang
- Wuhan Third Hospital & Tongren Hospital of Wuhan UniversityWuhanChina
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Hamzah R, Deevband MR, Ghorbani M, Khosravi M, Pour FS, Tavakoli M. Incidence risk assessment of secondary cancer due to radiotherapy of women with rectal cancer using BEIR VII, EPA, and ICRP models. Rep Pract Oncol Radiother 2023; 28:571-581. [PMID: 38179292 PMCID: PMC10764039 DOI: 10.5603/rpor.96870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 08/07/2023] [Indexed: 01/06/2024] Open
Abstract
Background Radiotherapy has a significant side effect known as radiation-induced secondary cancer. This study aims to evaluate the dose and secondary cancer risk for women with rectal cancer treated with three-dimensional conformal radiation therapy (3D-CRT) to the organs at risk (OARs) and some sensitive organs using different types of radiation-induced cancer risk prediction models, including Biological Effects of Ionizing Radiation (BEIRVII), Environmental Protection Agency (EPA) and International Commission on Radiological Protection (ICRP), and compare the results of the different models for same organs. Materials and methods Thirty female patients with rectal cancer were considered and dose calculations were based on the PCRT-3D treatment planning system, while the radiotherapy of the patients had been performed using Shinva linear accelerator with a total dose of 45 Gy at 25 fractions. Planning target volume (PTV), OARs, and some sensitive organs were contoured, three models were used to evaluate secondary cancer risk (SCR) using the excess relative risk (ERR) and excess absolute risk (EAR). Results The bladder presents the highest risk, in terms of ERR, and the femur head and uterus in terms of EAR from the three models (BEIR VII, EPA, and ICRP). Conclusion Based on the obtained results, radiotherapy of rectal cancer is relatively higher for the bladder and femur head, compared to the risk for other organs, the kidney risk is significantly lower. It was observed that the SCR from the ICRP model was higher compared to BEIR VII and EPA models.
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Affiliation(s)
- Rowaidah Hamzah
- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Deevband
- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Ghorbani
- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khosravi
- Medical Physics Department, Radiation Oncology Center, Vali Asr Hospital, Qom, Iran
| | - Faranak Sadeghi Pour
- Biomedical Engineering and Medical Physics Department, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meysam Tavakoli
- Department of Radiation Oncology, University of Pittsburgh School of Medicine and UPMC Hillman Cancer Center, Pittsburgh, PA, United States
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Shin TJ, Choe M, Kim BH, Byun SJ. Early Detection of Secondary Bladder Urothelial Carcinoma and Disseminated Bone Metastases with Normal Prostate-Specific Antigen Level after Pelvic Salvage Radiotherapy in Prostate Cancer. Life (Basel) 2023; 13:1249. [PMID: 37374033 DOI: 10.3390/life13061249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/17/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
This report describes the case of a 65-year-old man who presented with gross hematuria and a history of pelvic salvage radiotherapy for prostate cancer. Cystoscopy and transurethral resection of the bladder revealed urothelial carcinoma. Subsequently, disseminated bone metastases were detected with normal prostate-specific antigen (PSA) levels, and palliative radiotherapy and systemic chemotherapy were administered. Because gross hematuria can appear in both acute/chronic cystitis and bladder cancer in patients who have undergone pelvic radiotherapy for prostate cancer, close follow-up along with a detailed evaluation is needed. In addition, because prostate cancer disease progression with normal PSA levels may be associated with specific pathological findings, a detailed evaluation of symptoms and a careful review of pathologic reports are important.
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Affiliation(s)
- Teak Jun Shin
- Department of Urology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Misun Choe
- Department of Pathology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Byung Hoon Kim
- Department of Urology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
| | - Sang Jun Byun
- Department of Radiation Oncology, Keimyung University School of Medicine, Daegu 42601, Republic of Korea
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Butel-Simoes LE, Haw TJ, Williams T, Sritharan S, Gadre P, Herrmann SM, Herrmann J, Ngo DTM, Sverdlov AL. Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension-Mechanisms and Mitigation. Hypertension 2023; 80:685-710. [PMID: 36756872 PMCID: PMC10023512 DOI: 10.1161/hypertensionaha.122.17947] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Cardiovascular disease and cancer are 2 of the leading causes of death worldwide. Although improvements in outcomes have been noted for both disease entities, the success of cancer therapies has come at the cost of at times very impactful adverse events such as cardiovascular events. Hypertension has been noted as both, a side effect as well as a risk factor for the cardiotoxicity of cancer therapies. Some of these dynamics are in keeping with the role of hypertension as a cardiovascular risk factor not only for heart failure, but also for the development of coronary and cerebrovascular disease, and kidney disease and its association with a higher morbidity and mortality overall. Other aspects such as the molecular mechanisms underlying the amplification of acute and long-term cardiotoxicity risk of anthracyclines and increase in blood pressure with various cancer therapeutics remain to be elucidated. In this review, we cover the latest clinical data regarding the risk of hypertension across a spectrum of novel anticancer therapies as well as the underlying known or postulated pathophysiological mechanisms. Furthermore, we review the acute and long-term implications for the amplification of the development of cardiotoxicity with drugs not commonly associated with hypertension such as anthracyclines. An outline of management strategies, including pharmacological and lifestyle interventions as well as models of care aimed to facilitate early detection and more timely management of hypertension in patients with cancer and survivors concludes this review, which overall aims to improve both cardiovascular and cancer-specific outcomes.
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Affiliation(s)
- Lloyd E Butel-Simoes
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Tatt Jhong Haw
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Trent Williams
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Shanathan Sritharan
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Payal Gadre
- Department of Medicine, Hunter New England Local Health District, NSW, Australia
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Joerg Herrmann
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55902, USA
| | - Doan TM Ngo
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
| | - Aaron L Sverdlov
- Cardiovascular Department, John Hunter Hospital, Newcastle, NSW, Australia
- College of Health and Medicine, University of Newcastle, NSW Australia
- Newcastle Centre of Excellence in Cardio-Oncology, NSW, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW Australia
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Sun Q, Chen Y, Li T, Ni B, Zhu X, Xu B, Li J. Risk and prognosis of secondary esophagus cancer after radiotherapy for breast cancer. Sci Rep 2023; 13:3968. [PMID: 36894590 PMCID: PMC9998633 DOI: 10.1038/s41598-023-30812-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
Although radiation therapy (RT) improves locoregional recurrence and overall survival in breast cancer (BC), it is not yet clear whether RT affects the risk of patients with BC developing second esophageal cancer (SEC). We enrolled patients with BC as their first primary cancer from nine registries in the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2018. Fine-Gray competing risk regressions were assessed to determine the cumulative incidence of SECs. The standardized incidence ratio (SIR) was used to compare the prevalence of SECs among BC survivors to that in the general population of the US. Kaplan-Meier survival analysis was applied to calculate the 10-year overall survival (OS) and cancer-specific survival (CSS) rates for SEC patients. Among the 523,502 BC patients considered herein, 255,135 were treated with surgery and RT, while 268,367 had surgery without radiotherapy. In a competing risk regression analysis, receiving RT was associated with a higher risk of developing an SEC in BC patients than that in the patients not receiving RT (P = .003). Compared to the general population of the US, the BC patients receiving RT showed a greater incidence of SEC (SIR, 1.52; 95% confidence interval [CI], 1.34-1.71, P < .05). The 10-year OS and CSS rates of SEC patients after RT were comparable to those of the SEC patients after no RT. Radiotherapy was related to an increased risk of developing SECs in patients with BC. Survival outcomes for patients who developed SEC after RT were similar to those after no RT.
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Affiliation(s)
- Qianhui Sun
- Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China
| | - Yunru Chen
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Tingting Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Baoyi Ni
- Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China
| | - Xiaoyu Zhu
- Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China
| | - Bowen Xu
- Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China.,Beijing University of Chinese Medicine, Beijing, China
| | - Jie Li
- Oncology Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, No. 5, Beixian Pavilion, Xicheng District, Beijing, China.
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Lv X, Yue P, Zhou F. Risk and prognosis of secondary breast cancer after radiation therapy for non-Hodgkin lymphoma: a massive population-based analysis. Clin Transl Oncol 2022; 25:1307-1314. [PMID: 36478146 DOI: 10.1007/s12094-022-03026-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE One of the best ways to control non-Hodgkin lymphoma (NHL) locally is radiation therapy (RT), which is a crucial component of care for many patients. There has not been any research on the risk and prognosis of secondary breast cancer (SBC) in females with NHL receiving RT. METHODS In our study, females with NHL as their initial cancer diagnosis were included from 1975 to 2018 in the Surveillance, Epidemiology and End Results (SEER) database. Using Fine and Gray's competing risk regression assess the cumulative incidence of SBC. The standardized incidence ratios (SIR) and radiation-attributed risk (RR) for SBC were assessed using Poisson regression analysis. We evaluated the overall survival (OS) of SBC patients using the Kaplan-Meier technique. RESULTS Of the 41,983 females with NHL, 10,070 received RT and 320 (3.18%) developed SBC. 31,913 females did not receive RT and 805 (2.52%) developed SBC. RT was significantly related with a greater chance of acquiring SBC in the Fine-Gray competing risk regression (adjusted hazard ratios (HR) = 1.14; 95% confidence intervals (CI), 1.09-1.30; P = 0.011). When an NHL diagnosis was made at an older age, the dynamic SIR and RR for SBC also declined over time. Regarding general survivability, there was not statistically significant (P = 0.970) after propensity score matching (PSM). CONCLUSIONS RT is an independent risk factor for SBC in females with NHL. Special attention should be paid to the monitoring of breast cancer indicators in them, especially young.
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Affiliation(s)
- Xiaoyan Lv
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Pengpeng Yue
- National Quality Control Center for Donated Organ Procurement, Hubei Key Laboratory of Medical Technology on Transplantation, Hubei Clinical Research Center for Natural Polymer Biological Liver, Hubei Engineering Center of Natural Polymer-Based Medical Materials, Transplant Center of Wuhan University, Institute of Hepatobiliary Diseases of Wuhan University, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Fuling Zhou
- Department of Hematology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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Chen R, Zhan X, Jiang H, Liu Y, Jiang Z, Jiang M, Deng W, Liu X, Chen G, Fu B. Risk and prognosis of secondary malignant neoplasms after radiation therapy for bladder cancer: A large population-based cohort study. Front Oncol 2022; 12:953615. [DOI: 10.3389/fonc.2022.953615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/20/2022] [Indexed: 11/17/2022] Open
Abstract
ObjectiveTo investigate the association between radiotherapy and the risk of second malignant neoplasm (SMN) development among patients with bladder cancer (BC). Overall survival (OS) is compared among patients developing SMN and without.MethodWe identified patients diagnosed with BC from the Surveillance, Epidemiology, and End Results (SEER) database. The development of an SMN is defined as any SMN occurring more than 5 years after the diagnosis of BC. The Fine-Gray competing risk regression is used to estimate the probability of SMN. The radiotherapy-associated risk (RR) for SMNs is assessed by Poisson regression. The Kaplan–Meier method was used to evaluate the OS of patients with SMNs. Propensity score matching (PSM) is performed.ResultsA total of 76575 BC patients are enrolled in our study. The probability of SMNs in the radiotherapy cohort is statistically higher than in the non-radiotherapy cohort. In competing risk regression analysis, radiotherapy is proven to be associated with a higher risk of SMN (Hazard ratio: 1.23; 95% CI: 1.102–1.368). The radiotherapy-associated risks significantly increase in the radiotherapy cohort (RR: 1.28; 95% CI: 1.14–1.43). In site-specific analysis, statistically significant results are observed in lung and bronchus (LAB) cancer and hematological malignancies. The OS rate in patients developing SMN is significantly lower than that among matched patients with primary BC.ConclusionRadiotherapy for BC is associated with SMN. Radiotherapy increases the risk of secondary low-dose area cancer development, including LAB cancer or hematological malignancies. Notably, this effect is not observed in the high-dose area involving pelvic tumors. Patients developing SMN showed poorer OS.
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Neuzillet Y, Pradère B, Xylinas E, Allory Y, Audenet F, Loriot Y, Masson-Lecomte A, Roumiguié M, Seisen T, Traxer O, Leon P, Roupret M. French AFU Cancer Committee Guidelines - Update 2022-2024: Non-muscle-invasive bladder cancer (NMIBC). Prog Urol 2022; 32:1102-1140. [PMID: 36400479 DOI: 10.1016/j.purol.2022.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To update the ccAFU recommendations for the management of bladder tumours that do not infiltrate the bladder muscle (NBMIC). METHODS A systematic review (Medline) of the literature from 2020 to 2022 was performed, taking account of the diagnosis, treatment options and surveillance of NMIBC, while evaluating the references with their levels of evidence. RESULTS The diagnosis of NMIBC (Ta, T1, CIS) is made after complete full-thickness tumour resection. The use of bladder fluorescence and the indication of a second look (4-6 weeks) help to improve the initial diagnosis. The EORTC score is used to assess the risk of recurrence and/or tumour progression. Through the stratification of patients in low, intermediate and high-risk categories, adjuvant treatment can be proposed: intravesical chemotherapy (immediate postoperative, initiation regimen) or BCG (initiation and maintenance regimen) instillations, or even the indication of cystectomy for BCG-resistant patients. CONCLUSION Updating the ccAFU recommendations should contribute to improving patient management, as well as the diagnosis and treatment of NMIBC.
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Affiliation(s)
- Y Neuzillet
- Service d'Urologie, hôpital Foch, Université Paris Saclay, Suresnes, France.
| | - B Pradère
- Service d'Urologie UROSUD, Clinique Croix Du Sud, 31130 Quint-Fonsegrives, France
| | - E Xylinas
- Service d'Urologie, Hôpital Bichat-Claude Bernard AP-HP, Université Paris Cité, Paris, France
| | - Y Allory
- Service d'Anatomopathologie, Institut Curie, Université Paris Saclay, Saint-Cloud, France
| | - F Audenet
- Service d'Urologie, Hôpital Européen Georges-Pompidou AP-HP Centre, Université Paris Cité, Paris, France
| | - Y Loriot
- Service d'Oncologie Médicale, Institut Gustave Roussy, Villejuif, France
| | - A Masson-Lecomte
- Service d'Urologie, Hôpital Saint-Louis, Université de Paris, Paris, France
| | - M Roumiguié
- Service d'Urologie, CHU de Toulouse, UPS, Université de Toulouse, Toulouse, France
| | - T Seisen
- Sorbonne Université, GRC 5 Predictive Onco-Uro, AP-HP, Urologie, Hôpital Pitié-Salpetrière, 75013 Paris, France
| | - O Traxer
- Sorbonne Université, GRC#20 Lithiase Urinaire et EndoUrologie, AP-HP, Urologie, Hôpital Tenon, 75020 Paris, France
| | - P Leon
- Service d'Urologie, clinique Pasteur, Royan, France
| | - M Roupret
- Sorbonne Université, GRC 5 Predictive Onco-Uro, AP-HP, Urologie, Hôpital Pitié-Salpetrière, 75013 Paris, France
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Li S, Wei R, Yu G, Liu H, Chen T, Guan X, Wang X, Jiang Z. Risk and prognosis of secondary bladder cancer after radiation therapy for pelvic cancer. Front Oncol 2022; 12:982792. [PMID: 36091158 PMCID: PMC9449132 DOI: 10.3389/fonc.2022.982792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundRadiation therapy (RT) is a crucial modality for the local control of pelvic cancer (PC), but the effect of pelvic RT on the development of secondary malignancy is still unclear. This study aimed to identify the relationship between radiation therapy received for the treatment of primary PC and subsequent secondary bladder cancer (SBC).MethodsThe Surveillance, Epidemiology, and End Results (SEER) database (from 1975 to 2015) was queried for PC. Fine-gray competing risk regression and Cox regression analyses were employed to assess the cumulative incidence of SBC. Poisson regression and multiple primary standardized incidence ratios (SIR) were used to evaluate the radiotherapy-associated risk for patients receiving RT. Subgroup analyses of patients stratified by latency time since PC diagnosis, calendar year of PC diagnosis stage, and age at PC diagnosis were also performed. Overall survival (OS) was compared among different treatment groups with SBC by Kaplan–Meier analysis.ResultsA total of 318,165 observations showed that the primary cancers were located in pelvic cavity, 256,313 patients did not receive radiation therapy (NRT), 51,347 patients who underwent external beam radiation therapy (EBRT), and 10,505 patients receiving a combination of EBRT and brachytherapy (EBRT–BRT) who developed SBC. Receiving two types of radiotherapy was strongly consistent with a higher risk of developing SBC for PC patients in Fine-Gray competing risk regression (NRT vs. EBRT, adjusted HR= 1.71, 95% CI: 1.54-1.90, P<0.001; NRT vs. EBRT–BRT, adjusted HR= 2.16, 95% CI: 1.78-2.63, P<0.001). The results of the dynamic SIR and Poisson regression analysis for SBC revealed that a slightly increased risk of SBC was observed after RT in the early latency and was significantly related to the variations of age at PC diagnosis and decreased with time progress. For OS, the SBC after NRT, SBC after EBRT, and SBC after EBRT-BRT of 10-year survival rates were 37.9%, 29.2%, and 22.2%, respectively.ConclusionRadiotherapy for primary PC was associated with higher risks of developing SBC than patients unexposed to radiotherapy. Different pelvic RT treatment modalities had different effects on the risk of SBC.
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Affiliation(s)
| | | | | | | | | | - Xu Guan
- *Correspondence: Zheng Jiang, ; Xishan Wang, ; Xu Guan,
| | - Xishan Wang
- *Correspondence: Zheng Jiang, ; Xishan Wang, ; Xu Guan,
| | - Zheng Jiang
- *Correspondence: Zheng Jiang, ; Xishan Wang, ; Xu Guan,
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11
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Paterson DI, Wiebe N, Cheung WY, Mackey JR, Pituskin E, Reiman A, Tonelli M. Incident Cardiovascular Disease Among Adults With Cancer: A Population-Based Cohort Study. JACC CardioOncol 2022; 4:85-94. [PMID: 35492824 PMCID: PMC9040097 DOI: 10.1016/j.jaccao.2022.01.100] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 12/13/2022] Open
Abstract
Background Patients with cancer and cancer survivors are at increased risk for incident heart failure, but there are conflicting data on the long-term risk for other cardiovascular events and how such risk may vary by cancer site. Objectives The aim of this study was to determine the impact of a new cancer diagnosis on the risk for fatal and nonfatal cardiovascular events. Methods Using administrative health care databases, a population-based retrospective cohort study was conducted among 4,519,243 adults residing in Alberta, Canada, from April 2007 to December 2018. Participants with new cancer diagnoses during the study period were compared with those without cancer with respect to risk for subsequent cardiovascular events (cardiovascular mortality, myocardial infarction, stroke, heart failure, and pulmonary embolism) using time-to-event survival models after adjusting for sociodemographic data and comorbidities. Results A total of 224,016 participants with new cancer diagnoses were identified, as well as 73,360 cardiovascular deaths and 470,481 nonfatal cardiovascular events during a median follow-up period of 11.8 years. After adjustment, participants with cancer had HRs of 1.33 (95% CI: 1.29-1.37) for cardiovascular mortality, 1.01 (95% CI: 0.97-1.05) for myocardial infarction, 1.44 (95% CI: 1.41-1.47) for stroke, 1.62 (95% CI: 1.59-1.65) for heart failure, and 3.43 (95% CI: 3.37-3.50) for pulmonary embolism, compared with participants without cancer. Cardiovascular risk was highest for patients with genitourinary, gastrointestinal, thoracic, nervous system and hematologic malignancies. Conclusions A new cancer diagnosis is independently associated with a significantly increased risk for cardiovascular death and nonfatal morbidity regardless of cancer site. These findings highlight the need for a collaborative approach to health care for patients with cancer and cancer survivors.
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Affiliation(s)
- D. Ian Paterson
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Natasha Wiebe
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Winson Y. Cheung
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - John R. Mackey
- Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Edith Pituskin
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Anthony Reiman
- Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Address for correspondence: Dr Marcello Tonelli, University of Calgary, 7th Floor, TRW Building, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada. @cellotonelli
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Neoadjuvant Chemotherapy plus Bevacizumab Combined with Total Mesorectal Excision in Treating Locally Advanced Rectal Cancer Patients with BRAF Mutation: Clinical Benefit and Safety. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2021; 2021:4227650. [PMID: 34925539 PMCID: PMC8677386 DOI: 10.1155/2021/4227650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/08/2021] [Accepted: 11/18/2021] [Indexed: 11/29/2022]
Abstract
Objective To investigate clinical benefit and safety of neoadjuvant chemotherapy (NAC) plus bevacizumab combined with total mesorectal excision (TME) in treating patients with BRAF-mutated locally advanced rectal cancer (LARC). Methods This study included LARC patients with BRAF mutation admitted to the Oncology Department of Fujian Medical University Cancer Hospital, Fujian Cancer Hospital, between June 2013 and December 2018. Patients in the control group received a standard treatment regimen of TME combined with NAC (n = 45), and patients in the observation group received NAC plus bevacizumab combined with TME (n = 55). The short-term clinical efficacy of the two groups after NAC treatment was observed and compared, including differences in the pathological downstaging rate. The incidence of perioperative complications and adverse reactions during neoadjuvant therapy was compared to evaluate the safety of the treatment. Besides, the relapse-free survival (RFS) and overall survival (OS) of patients were analyzed to evaluate the long-term clinical benefit of the treatment. Results Compared with the control group, the ypT staging rate (p = 0.014) in the observation group was markedly lower. In addition, patients in the observation group had a prominently lower overall incidence of complications (p < 0.001) during the perioperative period and a remarkably lower incidence of leukopenia (p = 0.037) during neoadjuvant therapy. In terms of long-term clinical benefit, the RFS of patients in the observation group was evidently longer (p = 0.037) than that in the control group. Conclusion Compared with TME plus NAC treatment, the short-term and long-term clinical benefits are higher and safety is more favorable of NAC plus bevacizumab combined with TME in treating LARC patients.
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