Estimating the risk of developing secondary hematologic malignancies in patients with T1/T2 prostate cancer undergoing diverse treatment modalities: A large population‐based study
Autor: | Xueqin Chen, Hui Yan, Mingge Zhou, Yuetao Wang, Xiaofei Mo |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Oncology
Male Cancer Research Neoplasms Radiation-Induced medicine.medical_treatment Brachytherapy radiation therapy Prostate cancer Epidemiology Stage (cooking) Research Articles RC254-282 Leukemia Radiation-Induced Prostatectomy Lymphoma Non-Hodgkin Hazard ratio Age Factors Neoplasms. Tumors. Oncology. Including cancer and carcinogens Neoplasms Second Primary Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma prostate cancer Hodgkin Disease Leukemia Myeloid Acute Hematologic Neoplasms Leukemia Monocytic Acute Regression Analysis Cancer Prevention Research Article medicine.medical_specialty Risk Assessment Internal medicine Leukemia Myelogenous Chronic BCR-ABL Positive medicine Confidence Intervals Humans Radiology Nuclear Medicine and imaging Aged Proportional Hazards Models prostatectomy business.industry Prostatic Neoplasms medicine.disease Leukemia Lymphocytic Chronic B-Cell Confidence interval Radiation therapy Relative risk hematologic malignancy business SEER Program |
Zdroj: | Cancer Medicine, Vol 10, Iss 15, Pp 5338-5346 (2021) Cancer Medicine |
ISSN: | 2045-7634 |
Popis: | Background Patients with prostate cancer (PC) are at a high risk of developing secondary hematologic malignancies (SHMs) after radiation therapy (RT), while no study has assessed the relationship of different treatment modalities with the occurrence of SHMs after PC at early stage. This study aimed to investigate the risks of developing SHMs in patients with T1/T2 PC undergoing different treatment modalities. Methods Patients with T1/T2 PC were identified from the Surveillance, Epidemiology, and End Results database. Competing risk regression (CRR) model was performed to evaluate the hazard ratios (HRs) of developing SHMs. As SHMs scarcely occur, the relative risk (RR) analysis was employed to compare the risks of different treatment modalities associating with the development of SHMs. Results The CRR analysis showed that undergoing RT was associated with a higher risk of developing SHMs (external beam radiation therapy [EBRT]: HR = 1.21, 95% confidence interval [CI]: 1.10–1.34; radioactive implant [RI]: HR = 1.20, 95% CI: 1.06–1.36). As for different types of SHMs, EBRT, and RI were correlated with decreased risks of developing CLL (RR = 0.67, 0.72; 95% CI: 0.53–0.85, 0.54–0.96, respectively), but with the increased risks of developing NHL (RR = 1.18, 1.23; 95% CI: 1.02–1.35, 1.05–1.44, respectively); EBRT also showed increased risks of developing acute/ chronic myeloid leukemia (AML/CML, RR = 1.54, 1.56; 95% CI: 1.16–2.03,1.05–2.33, respectively); No increased risk of developing SHMs was detected in patients who only underwent prostatectomy. Conclusions Although RT was found to be associated with the increased risks of developing SHMs in patients with T1/T2 PC, this finding cannot be extended to diverse types of SHMs. RT was correlated with the increased risks of the development of NHL, AML, and CML, but with the decreased risk of developing CLL. Prostatectomy did not increase the risk of developing SHMs. Our study used a large population‐based analysis to estimate the risk of different radiation therapy modalities for second hematologic malignancies developing after T1/2 prostate cancer. External beam radiation therapy and radioactive implant were correlated with increased risks of acute/chronic myeloid leukemia but decreased risk of chronic lymphocytic leukemia. The impact of radiation therapy on second hematologic malignancies developing after T1/2 prostate cancer was different in various types of hematologic malignancies. |
Databáze: | OpenAIRE |
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