Incidence of malignant pleural mesothelioma after thoracic radiotherapy

• Published in: Cancer 1997-09, Vol.80 (5), p.948-950
• Main Authors: Neugut, Alfred I., Ahsan, Habibul, Antman, Karen H.
• Format: Article
• Language: English
• Subjects: breast carcinoma; Breast Neoplasms - radiotherapy; Cohort Studies; etiology; Female; Hodgkin Disease - radiotherapy; Hodgkin's disease; Humans; Incidence; Male; mesothelioma; Mesothelioma - epidemiology; Mesothelioma - etiology; Neoplasms, Radiation-Induced - epidemiology; Neoplasms, Radiation-Induced - etiology; Neoplasms, Second Primary - epidemiology; Neoplasms, Second Primary - etiology; Pleural Neoplasms - epidemiology; Pleural Neoplasms - etiology; radiation effect; radiotherapy; Radiotherapy - adverse effects; Retrospective Studies; Risk; second neoplasms; SEER Program; Thorax; United States - epidemiology
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/(SICI)1097-0142(19970901)80:5<948::AID-CNCR17>3.0.CO;2-W

BACKGROUND Although usually associated with asbestos exposure, a number of case reports have noted the occurrence of malignant pleural mesothelioma in patients who received radiotherapy (RT) to the thorax. METHODS The authors performed a retrospective cohort study utilizing 251,750 women registered with breast carcinoma in the Surveillance, Epidemiology, and End Results Program of the U.S. National Cancer Institute from 1973‐1993, 24.8% of whom received RT as part of their initial management, and 13,743 people with Hodgkin's disease, 50.6% of whom received RT as part of their initial management. RESULTS Six cases of malignant pleural mesothelioma were found: two in breast carcinoma patients treated with RT and four found in women not treated with RT. No cases occurred in the patients with Hodgkin's disease. The overall estimated relative risk for malignant pleural mesothelioma after RT was 1.56 (95% confidence interval, 0.18‐5.63). CONCLUSIONS To the authors' knowledge, this is the first controlled study to investigate thoracic radiation exposure and malignant pleural mesothelioma, and no association was found. Cancer 1997; 80:948‐50. © 1997 American Cancer Society. Multiple case reports have suggested that radiotherapy may increase the risk of mesothelioma. The authors used data from the Surveillance, Epidemiology, and End Results program to investigate the impact of thoracic radiotherapy on the risk of malignant pleural mesothelioma and found no association.