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Strahlenther Onkol. 2007 Nov;183(11):605-9.

Risk of second malignancies after prostate irradiation?

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  • 1Department of Radiooncology, University of Tübingen, Germany.

Abstract

PURPOSE:

Several recent SEER- (Surveillance, Epidemiology and End Results-) analyses gave rise to a highly controversial discussion in how far radiotherapy for prostate cancer is associated with an increased risk of secondary neoplasms.

MATERIAL AND METHODS:

In order to enable a rational discussion, the available literature was reviewed covering all publications from the mid 80s to January 2007.

RESULTS:

The reported numbers of secondary cancer (bladder, rectum, lung cancer and sarcoma) after irradiation were found to be increased in some publications. However, after age adjustment and correction for follow-up duration no clear increase was detectable.

DISCUSSION:

Up to now, all available data are highly heterogeneous. Thus, a low risk for secondary cancer cannot be ruled out completely. Nevertheless, it seems very unlikely that there is a relevant risk for secondary cancer since the largest of the published series did not document an increased risk for any secondary cancer.

CONCLUSION:

Only very large prospective studies which are designed to minimize the influence of possible confounders will be able to address the real risk of prostate irradiation-related cancer induction. The available data are clearly not valid and helpful for guiding any treatment decision.

[PubMed - indexed for MEDLINE]
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