Increased pancreatic cancer risk following radiotherapy for testicular cancer

Michael Hauptmann; Tom Børge Johannesen; Ethel S Gilbert; Marilyn Stovall; Flora E van Leeuwen; Preetha Rajaraman; Susan A Smith; Rita E Weathers; Berthe M P Aleman; Michael Andersson; Rochelle E Curtis; Graça M Dores; Joseph F Fraumeni; Per Hall; Eric J Holowaty; Heikki Joensuu; Magnus Kaijser; Ruth A Kleinerman; Frøydis Langmark; Charles F Lynch; Eero Pukkala; Hans H Storm; Leila Vaalavirta; Alexandra W van den Belt-Dusebout; Lindsay M Morton; Sophie D Fossa; Lois B Travis

doi:10.1038/bjc.2016.272

Increased pancreatic cancer risk following radiotherapy for testicular cancer

Michael Hauptmann, Tom Børge Johannesen, Ethel S Gilbert, Marilyn Stovall, Flora E van Leeuwen, Preetha Rajaraman, Susan A Smith, Rita E Weathers, Berthe M P Aleman, Michael Andersson, Rochelle E Curtis, Graça M Dores, Joseph F Fraumeni, Per Hall, Eric J Holowaty, Heikki Joensuu, Magnus Kaijser, Ruth A Kleinerman, Frøydis Langmark, Charles F LynchEero Pukkala, Hans H Storm, Leila Vaalavirta, Alexandra W van den Belt-Dusebout, Lindsay M Morton, Sophie D Fossa, Lois B Travis

30 Citationer (Scopus)

Abstract

BACKGROUND: Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear.

METHODS: Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs).

RESULTS: Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trend<0.001), with an OR of 4.6 (95% CI 1.9-11.0) for ⩾25 Gy vs <25 Gy. Radiation-related risks remained elevated ⩾20 years after TC diagnosis (P=0.020). The risk increased with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum.

CONCLUSIONS: A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.

Originalsprog	Engelsk
Tidsskrift	B J C
Vol/bind	115
Udgave nummer	7
Sider (fra-til)	901-8
Antal sider	8
ISSN	0007-0920
DOI	https://doi.org/10.1038/bjc.2016.272
Status	Udgivet - 27 sep. 2016

Adgang til dokumentet

10.1038/bjc.2016.272

Citationsformater

Hauptmann, M., Børge Johannesen, T., Gilbert, E. S., Stovall, M., van Leeuwen, F. E., Rajaraman, P., Smith, S. A., Weathers, R. E., Aleman, B. M. P., Andersson, M., Curtis, R. E., Dores, G. M., Fraumeni, J. F., Hall, P., Holowaty, E. J., Joensuu, H., Kaijser, M., Kleinerman, R. A., Langmark, F., ... Travis, L. B. (2016). Increased pancreatic cancer risk following radiotherapy for testicular cancer. B J C, 115(7), 901-8. https://doi.org/10.1038/bjc.2016.272

Hauptmann, M, Børge Johannesen, T, Gilbert, ES, Stovall, M, van Leeuwen, FE, Rajaraman, P, Smith, SA, Weathers, RE, Aleman, BMP, Andersson, M, Curtis, RE, Dores, GM, Fraumeni, JF, Hall, P, Holowaty, EJ, Joensuu, H, Kaijser, M, Kleinerman, RA, Langmark, F, Lynch, CF, Pukkala, E, Storm, HH, Vaalavirta, L, van den Belt-Dusebout, AW, Morton, LM, Fossa, SD & Travis, LB 2016, 'Increased pancreatic cancer risk following radiotherapy for testicular cancer', B J C, bind 115, nr. 7, s. 901-8. https://doi.org/10.1038/bjc.2016.272

@article{d8f542c2b14a4bf1a95558e9f84b6581,

title = "Increased pancreatic cancer risk following radiotherapy for testicular cancer",

abstract = "BACKGROUND: Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear.METHODS: Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs).RESULTS: Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trend<0.001), with an OR of 4.6 (95% CI 1.9-11.0) for ⩾25 Gy vs <25 Gy. Radiation-related risks remained elevated ⩾20 years after TC diagnosis (P=0.020). The risk increased with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum.CONCLUSIONS: A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.",

keywords = "Journal Article",

author = "Michael Hauptmann and {B{\o}rge Johannesen}, Tom and Gilbert, {Ethel S} and Marilyn Stovall and {van Leeuwen}, {Flora E} and Preetha Rajaraman and Smith, {Susan A} and Weathers, {Rita E} and Aleman, {Berthe M P} and Michael Andersson and Curtis, {Rochelle E} and Dores, {Gra{\c c}a M} and Fraumeni, {Joseph F} and Per Hall and Holowaty, {Eric J} and Heikki Joensuu and Magnus Kaijser and Kleinerman, {Ruth A} and Fr{\o}ydis Langmark and Lynch, {Charles F} and Eero Pukkala and Storm, {Hans H} and Leila Vaalavirta and {van den Belt-Dusebout}, {Alexandra W} and Morton, {Lindsay M} and Fossa, {Sophie D} and Travis, {Lois B}",

year = "2016",

month = sep,

day = "27",

doi = "10.1038/bjc.2016.272",

language = "English",

volume = "115",

pages = "901--8",

journal = "B J C",

issn = "0007-0920",

publisher = "Nature Publishing Group",

number = "7",

}

TY - JOUR

T1 - Increased pancreatic cancer risk following radiotherapy for testicular cancer

AU - Hauptmann, Michael

AU - Børge Johannesen, Tom

AU - Gilbert, Ethel S

AU - Stovall, Marilyn

AU - van Leeuwen, Flora E

AU - Rajaraman, Preetha

AU - Smith, Susan A

AU - Weathers, Rita E

AU - Aleman, Berthe M P

AU - Andersson, Michael

AU - Curtis, Rochelle E

AU - Dores, Graça M

AU - Fraumeni, Joseph F

AU - Hall, Per

AU - Holowaty, Eric J

AU - Joensuu, Heikki

AU - Kaijser, Magnus

AU - Kleinerman, Ruth A

AU - Langmark, Frøydis

AU - Lynch, Charles F

AU - Pukkala, Eero

AU - Storm, Hans H

AU - Vaalavirta, Leila

AU - van den Belt-Dusebout, Alexandra W

AU - Morton, Lindsay M

AU - Fossa, Sophie D

AU - Travis, Lois B

PY - 2016/9/27

Y1 - 2016/9/27

N2 - BACKGROUND: Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear.METHODS: Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs).RESULTS: Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trend<0.001), with an OR of 4.6 (95% CI 1.9-11.0) for ⩾25 Gy vs <25 Gy. Radiation-related risks remained elevated ⩾20 years after TC diagnosis (P=0.020). The risk increased with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum.CONCLUSIONS: A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.

AB - BACKGROUND: Pancreatic cancer risk is elevated among testicular cancer (TC) survivors. However, the roles of specific treatments are unclear.METHODS: Among 23 982 5-year TC survivors diagnosed during 1947-1991, doses from radiotherapy to the pancreas were estimated for 80 pancreatic cancer patients and 145 matched controls. Chemotherapy details were recorded. Logistic regression was used to estimate odds ratios (ORs).RESULTS: Cumulative incidence of second primary pancreatic cancer was 1.1% at 30 years after TC diagnosis. Radiotherapy (72 (90%) cases and 115 (80%) controls) was associated with a 2.9-fold (95% confidence interval (CI) 1.0-7.8) increased risk. The OR increased linearly by 0.12 per Gy to the pancreas (P-trend<0.001), with an OR of 4.6 (95% CI 1.9-11.0) for ⩾25 Gy vs <25 Gy. Radiation-related risks remained elevated ⩾20 years after TC diagnosis (P=0.020). The risk increased with the number of cycles of chemotherapy with alkylating or platinum agents (P=0.057), although only one case was exposed to platinum.CONCLUSIONS: A dose-response relationship exists between radiation to the pancreas and subsequent cancer risk, and persists for over 20 years. These excesses, although small, should be considered when radiotherapy with exposure to the pancreas is considered for newly diagnosed patients. Additional data are needed on the role of chemotherapy.

KW - Journal Article

U2 - 10.1038/bjc.2016.272

DO - 10.1038/bjc.2016.272

M3 - Journal article

C2 - 27599043

SN - 0007-0920

VL - 115

SP - 901

EP - 908

JO - B J C

JF - B J C

IS - 7

ER -

Increased pancreatic cancer risk following radiotherapy for testicular cancer

Abstract

Adgang til dokumentet

Fingeraftryk

Citationsformater