Prostate Cancer Radiation Therapy and Risk of Thromboembolic Events.
To investigate the risk of thromboembolic disease (TED) after radiation therapy (RT) with curative intent for prostate cancer (PCa).



We identified all men who received RT as curative treatment (n=9410) and grouped according to external beam RT (EBRT) or brachytherapy (BT). By comparing with an age- and county-matched comparison cohort of PCa-free men (n=46,826), we investigated risk of TED after RT using Cox proportional hazard regression models. The model was adjusted for tumor characteristics, demographics, comorbidities, PCa treatments, and known risk factors of TED, such as recent surgery and disease progression.



Between 2006 and 2013, 6232 men with PCa received EBRT, and 3178 underwent BT. A statistically significant association was found between EBRT and BT and risk of pulmonary embolism in the crude analysis. However, upon adjusting for known TED risk factors these associations disappeared. No significant associations were found between BT or EBRT and deep venous thrombosis.



Curative RT for prostate cancer using contemporary methodologies was not associated with an increased risk of TED.
Translational Oncology & Urology Research (TOUR), Division of Cancer Studies, King's College London, London, United Kingdom. Electronic address: Cecilia.t.bosco@kcl.ac.uk.
Cecilia
C
Bosco
Translational Oncology & Urology Research (TOUR), Division of Cancer Studies, King's College London, London, United Kingdom; Regional Cancer Centre, Uppsala, Akademiska Sjukhuset, Uppsala, Sweden.
Hans
H
Garmo
CLINTEC Department, Karolinska Institutet, Stockholm, Sweden.
Jan
J
Adolfsson
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden; Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
Pär
P
Stattin
Translational Oncology & Urology Research (TOUR), Division of Cancer Studies, King's College London, London, United Kingdom; Regional Cancer Centre, Uppsala, Akademiska Sjukhuset, Uppsala, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Lars
L
Holmberg
Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund University, Lund, Sweden.
Per
P
Nilsson
Department of Hematology, Oncology and Radiation Physics, Skane University Hospital, Lund University, Lund, Sweden.
Adalsteinn
A
Gunnlaugsson
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
Anders
A
Widmark
Translational Oncology & Urology Research (TOUR), Division of Cancer Studies, King's College London, London, United Kingdom; Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden.
Mieke
M
Van Hemelrijck
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000706:statistics & numerical data*; D015984:Causality; D015331:Cohort Studies; D018572:Disease-Free Survival; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis / Q000453:epidemiology*; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D013923:Thromboembolism / Q000175:diagnosis / Q000453:epidemiology*; D016896:Treatment Outcome