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Risk of subsequent primary cancers after carbon ion radiotherapy, photon radiotherapy, or surgery for localised prostate cancer: a propensity score-weighted, retrospective, cohort study
https://repo.qst.go.jp/records/49374
https://repo.qst.go.jp/records/49374ccfc4ad9-4075-496e-bed9-f40f7cab7b49
| Item type | 学術雑誌論文 / Journal Article(1) | |||||
|---|---|---|---|---|---|---|
| 公開日 | 2018-12-28 | |||||
| タイトル | ||||||
| タイトル | Risk of subsequent primary cancers after carbon ion radiotherapy, photon radiotherapy, or surgery for localised prostate cancer: a propensity score-weighted, retrospective, cohort study | |||||
| 言語 | ||||||
| 言語 | eng | |||||
| 資源タイプ | ||||||
| 資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
| 資源タイプ | journal article | |||||
| アクセス権 | ||||||
| アクセス権 | metadata only access | |||||
| アクセス権URI | http://purl.org/coar/access_right/c_14cb | |||||
| 著者 |
Mohamad, Osama
× Mohamad, Osama× Tabuchi, Takahiro× Nitta, Yuki× Nomoto, Akihiro× Sato, Akira× Kasuya, Goro× Makishima, Hirokazu× Choy, Hak× Yamada, Shigeru× Morishima, Toshitaka× Tsuji, Hiroshi× Miyashiro, Isao× Kamada, Tadashi× Mohamad, Osama× Nitta, Yuki× Nomoto, Akihiro× Kasuya, Goro× Makishima, Hirokazu× Yamada, Shigeru× Tsuji, Hiroshi× Kamada, Tadashi |
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| 抄録 | ||||||
| 内容記述タイプ | Abstract | |||||
| 内容記述 | Background: Photon radiotherapy increases the risk of subsequent primary cancers. Carbon ion radiotherapy has a theoretically lower risk of inducing malignancy, but the risk of subsequent malignancies after carbon ion radiotherapy has not been analyzed in detail yet. We thus aimed to analyze subsequent primary cancers after carbon ion radiotherapy and to compare the incidence of subsequent primary cancers between patients who had received carbon ion radiotherapy for prostate cancer and a population-based cohort of patients treated with photon radiotherapy or surgery. Methods: We reviewed the records of patients who received carbon ion radiotherapy for prostate cancer between 1994 and 2012 at the National Institute of Radiological Sciences in Japan and performed multivariable analysis to estimate predictors of subsequent cancers after carbon ion radiotherapy. Then, using propensity score inverse probability weighting, we retrospectively compared the incidence of subsequent cancers in patients with prostate cancer treated with carbon beams to that of patients treated with photons or surgery from the Osaka Cancer Registry. For all treatment groups, eligible patients were of any age, had localized prostate cancer excluding patients with metastasis, node positive or T4 prostate cancer, prior or synchronous malignancy, prior radiation or chemotherapy, and those with ≤3 months of follow-up. Findings: Out of 1580 patients who received carbon radiotherapy for prostate cancer between June 27th, 1995 and July 10th, 2012, 1455 patients met the eligibility criteria. After a median follow-up of 7·9 years (IQR 5.9-10.3), there were 234 subsequent primary cancers in the carbon ion radiotherapy cohort. On multivariable analysis, age and smoking were associated with a higher risk of subsequent primary cancers. Out of 38,594 Osaka cancer registry patients with prostate cancer treated between January 1994 and December 2012, 1983 patients treated with photon radiotherapy and 5948 treated with surgery were included. With a maximum follow-up of 10 years, median follow-up durations were 7.9 (IQR 5.9-10), 5·7 (IQR 4.5-6.4) and 6·0 (IQR 5.0-8.6) years in the carbon radiotherapy, photon radiotherapy, and surgery cohorts, respectively. After propensity score weighting, carbon ion radiotherapy was associated with a lower risk of subsequent primary cancers than photon radiotherapy (hazard ratio [HR] 0·81; 95% confidence interval [CI] 0·66-0·99), while photon radiotherapy was associated with a higher risk of subsequent primary cancers than surgery (HR 1·18; 95% CI 1·02-1·36). Compared to the general population, the carbon ion radiotherapy cohort did not show higher cancer risk in any sub-site. Bladder cancer risk, however, was higher in the photon radiotherapy cohort (standardized incidence ratio [SIR] 3·34; 95% CI 2·16-4·51), but not in the surgery cohort (SIR 1·45; 95% CI 0·99-1·87). Interpretation: Acknowledging the limitations in this study, carbon ion radiotherapy appears to have a lower risk of subsequent primary cancers than photon radiotherapy for patients with prostate cancer. Although prospective evaluation with longer follow-up is warranted to support these results, our data suggest a unique advantage of carbon ion radiotherapy and could support a wider but still cost-conscious adoption of this treatment in patients with expected long-term survival or those with poor outcomes with conventional treatments. Funding: This work was supported by the Research Project for Heavy Ions at the National Institute of Radiological Sciences. |
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| 書誌情報 |
The Lancet. Oncology 巻 20, 号 5, p. 674-685, 発行日 2019-03 |
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| 出版者 | ||||||
| 出版者 | Elsevier Ltd | |||||
| ISSN | ||||||
| 収録物識別子タイプ | ISSN | |||||
| 収録物識別子 | 1470-2045 | |||||
| PubMed番号 | ||||||
| 識別子タイプ | PMID | |||||
| 関連識別子 | 30885458 | |||||
| DOI | ||||||
| 識別子タイプ | DOI | |||||
| 関連識別子 | 10.1016/S1470-2045(18)30931-8 | |||||
| 関連サイト | ||||||
| 識別子タイプ | URI | |||||
| 関連識別子 | http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30931-8/fulltext | |||||
