Secondary Cancer in Prostate Cancer Patients Treated With Advanced External Beam Radiation Therapy.

IF 2.1 Q3 ONCOLOGY
International Journal of Particle Therapy Pub Date : 2024-08-23 eCollection Date: 2024-09-01 DOI:10.1016/j.ijpt.2024.100627
Sarah E Kulkarni, Sagar A Patel, Yuxian Sun, Ashesh B Jani, Theresa W Gillespie, Mark W McDonald, Yuan Liu
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引用次数: 0

Abstract

Purpose: Previous studies have shown that external beam radiation therapy is associated with an increased risk of second primary cancer (SPC) among prostate cancer (PCa) patients, but the relative risks associated with newer and advanced radiation modalities such as proton beam therapy (PBT) and stereotactic body radiation therapy (SBRT) are unclear. This study aimed to assess the relative probability of SPC among patients treated with these newer modalities compared to intensity-modulated radiation therapy (IMRT).

Patients and methods: Using the National Cancer Database (NCDB), N0M0 PCa cases diagnosed between 2004 and 2018 were identified. Second primary cancer probabilities were compared among those treated with curative-intent PBT, SBRT, and IMRT. Multivariable logistic regression and inverse probability of treatment weighting were used to generate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).

Results: In total, 133 898 patients were included, with a median age of 69 years and median follow-up of 6.4 years. As their first course of treatment, 3420 (2.6%) received PBT, 121 211 (90.5%) received IMRT, and 9267 (6.9%) received SBRT. Compared with IMRT, PBT and SBRT were associated with lower SPC risk (aORs and 95% CIs, PBT: 0.49 [0.40-0.60], SBRT: 0.57 (0.51-0.63), P < .001). Inverse probability of treatment weighting analyses corroborated these results.

Conclusion: In this large national cohort, PBT and SBRT performed similarly and were associated with reduced SPC risk compared to IMRT when used as the first course of treatment.

接受先进体外放射治疗的前列腺癌患者的继发性癌症
目的:以往的研究表明,体外放射治疗与前列腺癌(PCa)患者罹患第二原发癌(SPC)的风险增加有关,但质子束治疗(PBT)和立体定向体放射治疗(SBRT)等更新、更先进的放射模式的相关风险尚不清楚。本研究旨在评估与调强放射治疗(IMRT)相比,接受这些较新模式治疗的患者发生SPC的相对概率:通过国家癌症数据库(NCDB),确定了2004年至2018年间诊断的N0M0 PCa病例。比较了接受治愈性PBT、SBRT和IMRT治疗的患者的二次原发癌概率。采用多变量逻辑回归和逆治疗概率加权生成调整后的几率比(aORs)和95%置信区间(CIs):共纳入 133 898 例患者,中位年龄为 69 岁,中位随访时间为 6.4 年。3420名患者(2.6%)接受了PBT治疗,121211名患者(90.5%)接受了IMRT治疗,9267名患者(6.9%)接受了SBRT治疗。与 IMRT 相比,PBT 和 SBRT 与较低的 SPC 风险相关(aORs 和 95% CIs,PBT:0.49 [0.40-0.60],SBRT:0.57 (0.51-0.63),P 结论:在这一大型全国队列中,PBT 和 SBRT 的疗效相似,与 IMRT 相比,PBT 和 SBRT 在作为第一疗程时可降低 SPC 风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
International Journal of Particle Therapy
International Journal of Particle Therapy Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
3.70
自引率
5.90%
发文量
23
审稿时长
20 weeks
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