title: Second malignancies following conventional or combined ²⁵²Cf neutron brachytherapy with external beam radiotherapy for breast cancer.
abstract: We retrospectively evaluated the risk of second malignancies among 832 patients with inner or central breast cancer treated with conventional external beam schedule (CRT group), or neutron brachytherapy using Californium-252 (²⁵²Cf) sources and hypofractionated external beam radiotherapy (HRTC group), between 1987 and 1996 at the Institute of Oncology, Vilnius University. Patients were observed until the occurrences of death or development of a second malignancy, or until 31 December 2009, whichever was earlier. Median follow-up time was 10.4 years (range, 1.2-24.1 years). Risk of second primary cancers was quantified using standardized incidence ratios (SIRs). Cox proportional hazards regression models were used to estimate hazard ratios (HRs). There was a significant increase in the risk of second primary cancers compared with the general population (SIR 1.3, 95% CI 1.1-1.5). The observed number of second primary cancers was also higher than expected for breast (SIR 1.8, 95% CI 1.3-2.4) and lung cancer (SIR 3.8, 95% CI 2.0-6.7). For second breast cancer, no raised relative risk was observed during the period ≥10 or more years after radiotherapy. Compared with the CRT group, HRTC patients had a not statistically significant higher risk of breast cancer. Increased relative risks were observed specifically for age at initial diagnosis of <50 years (HR 2.9, 95% CI 1.6-5.2) and for obesity (HR 2.8, 95% CI 1.1-7.2).
authors: Institute of Oncology, Vilnius University, Santariskiu 1, LT-08660 Vilnius, Lithuania.
authors: Konstantinas Povilas
authors: KP
authors: Valuckas
authors: Vydmantas
authors: V
authors: Atkocius
authors: Irena
authors: I
authors: Kuzmickiene
authors: Eduardas
authors: E
authors: Aleknavicius
authors: Sarune
authors: S
authors: Liukpetryte
authors: Valerijus
authors: V
authors: Ostapenko
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000401:mortality*; D001943:Breast Neoplasms / Q000401:mortality* / Q000532:radiotherapy*; D002142:Californium / Q000627:therapeutic use*; D015331:Cohort Studies; D003131:Combined Modality Therapy / Q000401:mortality; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008097:Lithuania / Q000453:epidemiology; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000401:mortality*; D016609:Neoplasms, Second Primary / Q000401:mortality*; D009502:Neutrons; D019275:Radiopharmaceuticals / Q000627:therapeutic use; D020266:Radiotherapy, Conformal / Q000401:mortality*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D002142:Californium
keywords: 252Cf neutron brachytherapy; breast cancer radiotherapy; second cancer
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