Zhiguo Zhu1, Shankun Zhao1, Yangzhou Liu1, Jiamin Wang1, Lianmin Luo1, Ermao Li1, Chaofeng Zhang1, Jintai Luo1, Zhigang Zhao2. 1. Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China. 2. Department of Urology & Andrology, Minimally Invasive Surgery Center, Guangdong Provincial Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510230, Guangdong, China. zgzhaodr@126.com.
Abstract
PURPOSE: To investigate whether radiotherapy for prostate cancer increases the risk of therapy-related rectal cancer and colon cancer. METHODS: A systematic literature search was carried out using the Medline (PubMed), EMBASE, and the Cochrane Library to identify studies examining the association between radiotherapy for prostate cancer and secondary colorectal cancer (rectal cancer and colon cancer) published before March 19, 2018. The risk of second colorectal cancer after radiotherapy was summarized using unadjusted odds ratio (OR) and adjusted hazard ratio (HR) with their 95% confidence interval (CI). Subgroup and sensitivity analyses were conducted to detect potential bias and heterogeneity. RESULTS: After study selection, 16 reports were retrieved for analysis. When patients received radiotherapy compared with those unexposed to radiation, there was an increased risk of the rectal cancer (OR 1.37, 95%CI 1.01 to 1.85), but not colon cancer. According to adjusted HR, there was an increased risk of the rectal cancer (HR 1.64, 95%CI 1.39 to 1.94), and colon cancer (HR 1.33, 95%CI 1.02 to 1.76). The OR for rectal cancer showed an increased risk with longer latent period (5 years lag time versus 10 years lag time, OR: 1.56 versus 2.22). Brachytherapy had no association with second cancer across all analyses. CONCLUSIONS: Radiotherapy was associated with an increased risk of subsequent rectal cancer compared with patients unexposed to radiation. Colon may be free from the damage of radiation. Brachytherapy had no association with second rectal cancer or colon cancer.
PURPOSE: To investigate whether radiotherapy for prostate cancer increases the risk of therapy-related rectal cancer and colon cancer. METHODS: A systematic literature search was carried out using the Medline (PubMed), EMBASE, and the Cochrane Library to identify studies examining the association between radiotherapy for prostate cancer and secondary colorectal cancer (rectal cancer and colon cancer) published before March 19, 2018. The risk of second colorectal cancer after radiotherapy was summarized using unadjusted odds ratio (OR) and adjusted hazard ratio (HR) with their 95% confidence interval (CI). Subgroup and sensitivity analyses were conducted to detect potential bias and heterogeneity. RESULTS: After study selection, 16 reports were retrieved for analysis. When patients received radiotherapy compared with those unexposed to radiation, there was an increased risk of the rectal cancer (OR 1.37, 95%CI 1.01 to 1.85), but not colon cancer. According to adjusted HR, there was an increased risk of the rectal cancer (HR 1.64, 95%CI 1.39 to 1.94), and colon cancer (HR 1.33, 95%CI 1.02 to 1.76). The OR for rectal cancer showed an increased risk with longer latent period (5 years lag time versus 10 years lag time, OR: 1.56 versus 2.22). Brachytherapy had no association with second cancer across all analyses. CONCLUSIONS: Radiotherapy was associated with an increased risk of subsequent rectal cancer compared with patients unexposed to radiation. Colon may be free from the damage of radiation. Brachytherapy had no association with second rectal cancer or colon cancer.
Authors: Mike E Robbins; Judy K Brunso-Bechtold; Ann M Peiffer; Christina I Tsien; Janet E Bailey; Lawrence B Marks Journal: Radiat Res Date: 2012-02-21 Impact factor: 2.841
Authors: Stephen Boorjian; Janet E Cowan; Badrinath R Konety; Janeen DuChane; Ashutosh Tewari; Peter R Carroll; Christopher J Kane Journal: J Urol Date: 2007-03 Impact factor: 7.450
Authors: Lois B Travis; Wendy Demark Wahnefried; James M Allan; Marie E Wood; Andrea K Ng Journal: Nat Rev Clin Oncol Date: 2013-03-26 Impact factor: 66.675
Authors: Timothy S Nugent; Ernest Z Low; Matthew R Fahy; Noel E Donlon; Paul H McCormick; Brian J Mehigan; Moya Cunningham; Charles Gillham; Dara O Kavanagh; Michael E Kelly; John O Larkin Journal: Int J Colorectal Dis Date: 2022-01-17 Impact factor: 2.571