title: Pattern of solid and hematopoietic second malignancy after local therapy for prostate cancer.
abstract: Second malignancies (SM) after external beam radiotherapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa) are rare but serious sequelae.
  
  
  
  The Surveillance, Epidemiology, and End Results (SEER) database was used to identify men diagnosed with cT1-2N0M0 PCa between 1999 and 2005, who underwent EBRT, BT or radical prostatectomy (RP). Patients with time interval to second malignancy or follow-up shorter than five and two years were excluded for solid and hematopoietic SM analyses respectively. Risks for solid and hematopoietic SM were evaluated via the multivariate Fine and Gray proportional hazards model.
  
  
  
  EBRT and BT resulted in similar increases in solid and hematopoietic SM compared to RP. In subgroup analysis stratified by treatment modality, only the EBRT cohort demonstrated significantly decreased solid and hematopoietic SM in years 2002-2005 compared to years 1999-2001, with adjusted-hazard ratios of 0.752 (p=0.001) and 0.815 (p=0.018) respectively.
  
  
  
  EBRT and BT resulted in statistically equivalent increase in both solid and hematopoietic SM compared to RP. EBRT in more recent years resulted in significantly decreased solid and hematopoietic SM, coinciding with increased utilization of IMRT.
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States. Electronic address: chenyangwang@mednet.ucla.edu.
authors.forename: Chenyang
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: King
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Mitchell
authors.initials: M
authors.lastname: Kamrava
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Keisuke S
authors.initials: KS
authors.lastname: Iwamoto
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Allen M
authors.initials: AM
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Low
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Kupelian
authors.affiliation: Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA, United States.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Steinberg
mesh_terms: D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000453:epidemiology*; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery
keywords: Brachytherapy; External beam radiotherapy; Prostate cancer; Second malignancy