Journal article
Increased stomach cancer risk following radiotherapy for testicular cancer
British journal of cancer, Vol.112(1), pp.44-51
01/06/2015
DOI: 10.1038/bjc.2014.552
PMCID: PMC4453604
PMID: 25349972
Abstract
Abdominal radiotherapy for testicular cancer (TC) increases risk for second stomach cancer, although data on the radiation dose-response relationship are sparse.
In a cohort of 22,269 5-year TC survivors diagnosed during 1959-1987, doses to stomach subsites were estimated for 92 patients who developed stomach cancer and 180 matched controls. Chemotherapy details were recorded. Odds ratios (ORs) were estimated using logistic regression.
Cumulative incidence of second primary stomach cancer was 1.45% at 30 years after TC diagnosis. The TC survivors who received radiotherapy (87 (95%) cases, 151 (84%) controls) had a 5.9-fold (95% confidence interval (CI) 1.7-20.7) increased risk of stomach cancer. Risk increased with increasing stomach dose (P-trend<0.001), with an OR of 20.5 (3.7-114.3) for ⩾50.0 Gy compared with <10 Gy. Radiation-related risks remained elevated ⩾20 years after exposure (P<0.001). Risk after any chemotherapy was not elevated (OR=1.1; 95% CI 0.5-2.5; 14 cases and 23 controls).
Radiotherapy for TC involving parts of the stomach increased gastric cancer risk for several decades, with the highest risks after stomach doses of ⩾30 Gy. Clinicians should be aware of these excesses when previously irradiated TC survivors present with gastrointestinal symptoms and when any radiotherapy is considered in newly diagnosed TC patients.
Details
- Title: Subtitle
- Increased stomach cancer risk following radiotherapy for testicular cancer
- Creators
- M Hauptmann - Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The NetherlandsS D Fossa - Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, NorwayM Stovall - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USAF E van Leeuwen - Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The NetherlandsT B Johannesen - Cancer Registry of Norway, Oslo, NorwayP Rajaraman - National Institutes of HealthE S Gilbert - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USAS A Smith - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USAR E Weathers - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USAB M P Aleman - 1] Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The NetherlandsM Andersson - Department of Oncology, Copenhagen University Hospital, Copenhagen, DenmarkR E Curtis - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USAG M Dores - 1] Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA Department of Veterans Affairs Medical Center, Oklahoma City, OK, USAJ F Fraumeni - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USAP Hall - 1] Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, SwedenE J Holowaty - Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, CanadaH Joensuu - Department of Oncology, Helsinki University Central Hospital, Helsinki, FinlandM Kaijser - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenR A Kleinerman - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USAF Langmark - Cancer Registry of Norway, Oslo, NorwayC F Lynch - Department of Epidemiology, University of Iowa, Iowa City, IA, USAE Pukkala - 1] Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland School of Health Sciences, University of Tampere, Tampere, FinlandH H Storm - Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, DenmarkL Vaalavirta - Department of Oncology, Helsinki University Central Hospital, Helsinki, FinlandA W van den Belt-Dusebout - Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The NetherlandsL B Travis - Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY, USAL M Morton - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA
- Resource Type
- Journal article
- Publication Details
- British journal of cancer, Vol.112(1), pp.44-51
- DOI
- 10.1038/bjc.2014.552
- PMID
- 25349972
- PMCID
- PMC4453604
- NLM abbreviation
- Br J Cancer
- ISSN
- 1532-1827
- eISSN
- 1532-1827
- Publisher
- England
- Grant note
- 1R01 CA 157823-01A1 / NCI NIH HHS P30 ES005605 / NIEHS NIH HHS N02CP31003 / NCI NIH HHS N02CP31136 / NCI NIH HHS N01CP31154 / NCI NIH HHS N01-CP-31155 / NCI NIH HHS N01-CP-31157 / NCI NIH HHS N01CP31156 / NIAID NIH HHS N01CP31019 / NCI NIH HHS N01-CP-31003 / NCI NIH HHS N01-CP-31156 / NCI NIH HHS R01 CA157823 / NCI NIH HHS N02CP55503 / NCI NIH HHS
- Language
- English
- Date published
- 01/06/2015
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995103102771
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