BACKGROUND: Adjuvant radiotherapy is common for uterine corpus cancer patients, yet the long-term carcinogenic effects of different types of radiotherapy have not been studied adequately. METHODS: Second primary cancer risks were quantified in a cohort of 60,949 individuals surviving > or = 1 year of uterine corpus cancer diagnosed from 1973 to 2003 in Surveillance, Epidemiology and End Results Program cancer registries. Incidence rate ratios (IRR) were estimated by comparing patients treated with surgery plus various types of radiotherapy with patients receiving surgery only. RESULTS: The IRRs of a second cancer were increased among irradiated patients compared with patients having surgery only [combination radiotherapy, IRR = 1.26; 95% confidence interval (CI), 1.16-1.36; external beam therapy, IRR = 1.15; 95% CI CI, 1.08-1.22; brachytherapy, IRR = 1.07; 95% CI, 1.00-1.16]. IRRs were highest for heavily irradiated sites (that is colon, rectum, and bladder) and for leukemia following any external beam therapy, with the largest risks for solid cancers among 10-year survivors. Any external beam therapy had a 44% higher cancer risk at heavily irradiated sites than brachytherapy when the two treatments were directly compared (5-year survivors: IRR = 1.44; 95% CI, 1.19-1.75). We estimated that of 2,012 solid cancers developing > or = 5 years after irradiation, 213 (11%) could be explained by radiotherapy. CONCLUSIONS: Radiotherapy for uterine cancer increases the risk of leukemia and second solid cancers at sites in close proximity to the uterus, emphasizing the need for continued long-term surveillance for new malignancies. The overall risk of a second cancer was lower following brachytherapy compared with any external beam radiotherapy.
BACKGROUND: Adjuvant radiotherapy is common for uterine corpus cancerpatients, yet the long-term carcinogenic effects of different types of radiotherapy have not been studied adequately. METHODS: Second primary cancer risks were quantified in a cohort of 60,949 individuals surviving > or = 1 year of uterine corpus cancer diagnosed from 1973 to 2003 in Surveillance, Epidemiology and End Results Program cancer registries. Incidence rate ratios (IRR) were estimated by comparing patients treated with surgery plus various types of radiotherapy with patients receiving surgery only. RESULTS: The IRRs of a second cancer were increased among irradiated patients compared with patients having surgery only [combination radiotherapy, IRR = 1.26; 95% confidence interval (CI), 1.16-1.36; external beam therapy, IRR = 1.15; 95% CI CI, 1.08-1.22; brachytherapy, IRR = 1.07; 95% CI, 1.00-1.16]. IRRs were highest for heavily irradiated sites (that is colon, rectum, and bladder) and for leukemia following any external beam therapy, with the largest risks for solid cancers among 10-year survivors. Any external beam therapy had a 44% higher cancer risk at heavily irradiated sites than brachytherapy when the two treatments were directly compared (5-year survivors: IRR = 1.44; 95% CI, 1.19-1.75). We estimated that of 2,012 solid cancers developing > or = 5 years after irradiation, 213 (11%) could be explained by radiotherapy. CONCLUSIONS: Radiotherapy for uterine cancer increases the risk of leukemia and second solid cancers at sites in close proximity to the uterus, emphasizing the need for continued long-term surveillance for new malignancies. The overall risk of a second cancer was lower following brachytherapy compared with any external beam radiotherapy.
Authors: Anil K Chaturvedi; Eric A Engels; Ethel S Gilbert; Bingshu E Chen; Hans Storm; Charles F Lynch; Per Hall; Froydis Langmark; Eero Pukkala; Magnus Kaijser; Michael Andersson; Sophie D Fosså; Heikki Joensuu; John D Boice; Ruth A Kleinerman; Lois B Travis Journal: J Natl Cancer Inst Date: 2007-10-30 Impact factor: 13.506
Authors: Sanjeev Kumar; Jay P Shah; Christopher S Bryant; Awoniyi O Awonuga; Anthony N Imudia; Julie J Ruterbusch; Michele L Cote; Rouba Ali-Fehmi; Robert T Morris; John M Malone Journal: Gynecol Oncol Date: 2009-02-26 Impact factor: 5.482
Authors: Jennifer Rhoades; Monica Hagan Vetter; James L Fisher; David E Cohn; Ritu Salani; Ashley S Felix Journal: Int J Gynecol Cancer Date: 2018-12-21 Impact factor: 3.437
Authors: Amy Berrington de Gonzalez; Rochelle E Curtis; Stephen F Kry; Ethel Gilbert; Stephanie Lamart; Christine D Berg; Marilyn Stovall; Elaine Ron Journal: Lancet Oncol Date: 2011-04 Impact factor: 41.316
Authors: Ashley S Felix; Faina Linkov; G Larry Maxwell; Camille Ragin; Emanuela Taioli Journal: Int J Gynecol Cancer Date: 2011-02-01 Impact factor: 3.437
Authors: Ruth A Kleinerman; Susan A Smith; Eric Holowaty; Per Hall; Eero Pukkala; Leila Vaalavirta; Marilyn Stovall; Rita Weathers; Ethel Gilbert; Berthe M P Aleman; Magnus Kaijser; Michael Andersson; Hans Storm; Heikki Joensuu; Charles F Lynch; Graça M Dores; Lois B Travis; Lindsay M Morton; Rochelle E Curtis Journal: Int J Radiat Oncol Biol Phys Date: 2013-05-22 Impact factor: 7.038
Authors: Ritsu Sakata; Ruth A Kleinerman; Kiyohiko Mabuchi; Marilyn Stovall; Susan A Smith; Rita Weathers; Jean Wactawski-Wende; Diane L Cookfair; John D Boice; Peter D Inskip Journal: Radiat Res Date: 2012-08-02 Impact factor: 2.841
Authors: Amanda Black; Todd M Gibson; Meredith S Shiels; Yikyung Park; Kim Robien; Demetrius Albanes; Stephanie J Weinstein; Laura E Beane Freeman; Gabriella Andreotti; Mark P Purdue; Joseph F Fraumeni; Patricia Hartge; Margaret A Tucker; Robert N Hoover; James R Cerhan; Anne Zeleniuch-Jacquotte; Rochelle E Curtis; Joanne Elena; Joshua N Sampson; Amy Berrington de Gonzalez; Lindsay M Morton Journal: Cancer Epidemiol Biomarkers Prev Date: 2014-05-15 Impact factor: 4.254