Second malignancies following conventional or combined [sup.252]Cf neutron brachytherapy with external beam radiotherapy for breast cancer

• Published in: Journal of radiation research 2013-09, Vol.54 (5), p.872
• Main Authors: Valuckas, Konstantinas Povilas, Atkocius, Vydmantas, Kuzmickiene, Irena, Aleknavicius, Eduardas, Liukpetryte, Sarune, Ostapenko, Valerijus
• Format: Article
• Language: English
• Subjects: Analysis; Brachytherapy; Breast cancer; Care and treatment; Health aspects; Ionizing radiation
• ISSN: 0449-3060
• DOI: 10.1093/jrr/rrt009

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 ([sup.252]Cf) 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 [greater than or equal]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