ترجمه مقاله نقش ضروری ارتباطات 6G با چشم انداز صنعت 4.0
- مبلغ: ۸۶,۰۰۰ تومان
ترجمه مقاله پایداری توسعه شهری، تعدیل ساختار صنعتی و کارایی کاربری زمین
- مبلغ: ۹۱,۰۰۰ تومان
Background The aim of this study was to analyse the association between pelvic radiation therapy (RT) and the development of rectal cancer as a second primary cancer.
Methods Data on patients treated for a primary pelvic cancer between 1989 and 2007 were retrieved from the population-based Netherlands Cancer Registry. Patients treated for more than one pelvic cancer were excluded. To estimate the cumulative incidence of rectal cancer, Fine and Gray's competing risk model was used with death as a competing event. Survival was calculated using multivariable Cox regression.
Results A total of 192,658 patients were included, of which 62,630 patients were treated with RT for their pelvic cancer. Primary tumours were located in the prostate (50.1%), bladder (19.2%), endometrium (13.9%), ovaries (10.0%), cervix (6.4%) and vagina (0.4%). At a median interval of 6 years (range 0–24), 1369 patients developed a rectal cancer. Overall, the risk for rectal cancer was increased in patients who underwent RT for the previous pelvic cancer (subhazard ratio [SHR]: 1.72, 95% confidence interval [CI]: 1.55–1.91). Analysis for each tumour location specifically showed an increased risk in patients who received RT for prostate (SHR: 1.89, 95% CI: 1.66–2.16) or endometrial cancer (SHR: 1.50, 95% CI: 1.13–2.00). A protective effect of RT was observed for patients with bladder cancer (SHR 0.67, 95% CI: 0.47–0.94). There was no survival difference between patients with rectal cancer with or without previous RT (hazard ratio: 0.94, 95% CI: 0.79–1.11).
Conclusions Patients who received RT for a previous pelvic cancer were at increased risk for rectal cancer. The risk was modest and pronounced in patients receiving RT for prostate and endometrial cancer.
1. Introduction
Compared with the general population, cancer survivors have an increased risk of developing new malignancies [1,2]. This is the result of a combination of factors such as lifestyle, genetic susceptibility and type of treatment for their previous cancer [3,4]. Radiation therapy (RT) is part of the treatment regimen in at least 50% of all patients with cancer and has been associated with the development of second primary cancers [3e5]. However, recent studies have shown that in some cases, RT does not increase the risk for a second primary cancer and might even have a preventive effect [2,6,7].
5. Conclusions
Patients who received RT for pelvic cancer were at increased risk for rectal cancer as a second primary cancer. However, its incidence is low and analysis per primary pelvic organ specifically showed an increased risk after prostate and endometrial cancer treatment only. Patients with previous RT for bladder cancer had a decreased risk for rectal cancer. There was no difference in survival after diagnosis of rectal cancer depending on their history of RT.