Estimation of second cancer risk after radiotherapy for rectal cancer: comparison of 3D conformal radiotherapy and volumetric modulated arc therapy using different high dose fractionation schemes
To investigate second cancer risk (SCR) comparing volumetric modulated arc therapy (VMAT) and 3D conformal radiotherapy (3DCRT) with different high dose fractionation schemes. VMAT and 3DCRT virtual treatment plans for 25 patients previously treated with radiotherapy for rectal cancer were evaluated...
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| Veröffentlicht in: | Radiation oncology (London, England) England), 2016-11, Vol.11 (1), p.149, Article 149 |
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| creator | Zwahlen, Daniel R Bischoff, Laura I Gruber, Günther Sumila, Marcin Schneider, Uwe |
| description | To investigate second cancer risk (SCR) comparing volumetric modulated arc therapy (VMAT) and 3D conformal radiotherapy (3DCRT) with different high dose fractionation schemes.
VMAT and 3DCRT virtual treatment plans for 25 patients previously treated with radiotherapy for rectal cancer were evaluated retrospectively. Doses prescribed were 25 × 1.8 Gy and 5 × 5 Gy, respectively. SCR was estimated using a carcinogenesis model and epidemiological data for carcinoma and sarcoma induction. SCR was determined by lifetime attributable risk (LAR).
Mean excess LAR was highest for organs adjacent to the PTV. Total LAR for VMAT and 3DCRT was 2.3-3.0 and 2.0-2.7 %, respectively. For 5 × 5 Gy, LAR was 1.4-1.9 % for VMAT and 1.2-1.6 % for 3DCRT. Organ-specific excess LAR was significantly higher for VMAT, and highest for bladder and colon. Size and shape of the PTV influenced SCR and was highest for age ≤ 40 years. For a patient with an additional lifetime risk of 60 years, LAR was 10 % for 25 × 1.8 Gy and 6 % for 5 × 5 Gy.
No statistically significant difference was detected in SCR using VMAT or 3DCRT. For bladder and colon, organ-specific excess LAR was statistically lower using 3DCRT, however the difference was small. Compared to epidemiological data, SCR was smaller when using a hypofractionated schedule. SCR was 2 % higher at normal life expectancy.
ClinicalTrials.gov Identifier NCT02572362 . Registered 4 October 2015. Retrospectively registered. |
| doi_str_mv | 10.1186/s13014-016-0723-6 |
| format | Article |
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VMAT and 3DCRT virtual treatment plans for 25 patients previously treated with radiotherapy for rectal cancer were evaluated retrospectively. Doses prescribed were 25 × 1.8 Gy and 5 × 5 Gy, respectively. SCR was estimated using a carcinogenesis model and epidemiological data for carcinoma and sarcoma induction. SCR was determined by lifetime attributable risk (LAR).
Mean excess LAR was highest for organs adjacent to the PTV. Total LAR for VMAT and 3DCRT was 2.3-3.0 and 2.0-2.7 %, respectively. For 5 × 5 Gy, LAR was 1.4-1.9 % for VMAT and 1.2-1.6 % for 3DCRT. Organ-specific excess LAR was significantly higher for VMAT, and highest for bladder and colon. Size and shape of the PTV influenced SCR and was highest for age ≤ 40 years. For a patient with an additional lifetime risk of 60 years, LAR was 10 % for 25 × 1.8 Gy and 6 % for 5 × 5 Gy.
No statistically significant difference was detected in SCR using VMAT or 3DCRT. For bladder and colon, organ-specific excess LAR was statistically lower using 3DCRT, however the difference was small. Compared to epidemiological data, SCR was smaller when using a hypofractionated schedule. SCR was 2 % higher at normal life expectancy.
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VMAT and 3DCRT virtual treatment plans for 25 patients previously treated with radiotherapy for rectal cancer were evaluated retrospectively. Doses prescribed were 25 × 1.8 Gy and 5 × 5 Gy, respectively. SCR was estimated using a carcinogenesis model and epidemiological data for carcinoma and sarcoma induction. SCR was determined by lifetime attributable risk (LAR).
Mean excess LAR was highest for organs adjacent to the PTV. Total LAR for VMAT and 3DCRT was 2.3-3.0 and 2.0-2.7 %, respectively. For 5 × 5 Gy, LAR was 1.4-1.9 % for VMAT and 1.2-1.6 % for 3DCRT. Organ-specific excess LAR was significantly higher for VMAT, and highest for bladder and colon. Size and shape of the PTV influenced SCR and was highest for age ≤ 40 years. For a patient with an additional lifetime risk of 60 years, LAR was 10 % for 25 × 1.8 Gy and 6 % for 5 × 5 Gy.
No statistically significant difference was detected in SCR using VMAT or 3DCRT. For bladder and colon, organ-specific excess LAR was statistically lower using 3DCRT, however the difference was small. Compared to epidemiological data, SCR was smaller when using a hypofractionated schedule. SCR was 2 % higher at normal life expectancy.
ClinicalTrials.gov Identifier NCT02572362 . Registered 4 October 2015. Retrospectively registered.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Colorectal cancer</subject><subject>Diagnosis</subject><subject>Dose Fractionation</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasms, Radiation-Induced - epidemiology</subject><subject>Neoplasms, Second Primary - epidemiology</subject><subject>Organs at Risk - radiation effects</subject><subject>Patient outcomes</subject><subject>Prognosis</subject><subject>Radiotherapy</subject><subject>Radiotherapy Planning, Computer-Assisted</subject><subject>Radiotherapy, Conformal - adverse effects</subject><subject>Radiotherapy, Intensity-Modulated - adverse effects</subject><subject>Rectal Neoplasms - radiotherapy</subject><subject>Relapse</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk factors</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptks1q3DAUhU1paNK0D9BNEXTtRFe29dNFISRpGwhkk0J3QqOfsVLbmkpyIM_XF6sGT8IMxF5YXH_ncHQ5VfUJ8BkAp-cJGgxtjYHWmJGmpm-qE2Atrxmw32_3zsfV-5QeMG67Bot31TFhvCFMiJPq33XKflTZhwkFh5LVYTJIq0nbiKJPf5ByeXtUxofc26g2T8iFMrA6q2FHfkU6jBtV-MWmuSqDqWBjQQ6kqrg_hmEebY5eozGYeVDZGqSiRs_QnPy0RsY7Z6OdMur9ukcmJItcVHqbdQmcdG9Hmz5UR04NyX7cfU-rX9-v7y9_1rd3P24uL25r3Yo215pxoznpGDUaU0UciE4RAthxDLalBlPsKF6x8igDxgkGBne8wysC7Uo1p9W3xXczr0ZrdIkW1SA3sSwwPsmgvDz8M_lersOj7AA3nRDF4MvOIIa_s01ZPoQ5TiWzBN5SEASTPWqtBit9WWMx06NPWl60VHBMKIdCnb1CldfY0ZflW-fL_EAAi0DHkFK07iU4YLmtk1zqJEud5LZOkhbN5_0bvyie-9P8BwM2yoY</recordid><startdate>20161110</startdate><enddate>20161110</enddate><creator>Zwahlen, Daniel R</creator><creator>Bischoff, Laura I</creator><creator>Gruber, Günther</creator><creator>Sumila, Marcin</creator><creator>Schneider, Uwe</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope></search><sort><creationdate>20161110</creationdate><title>Estimation of second cancer risk after radiotherapy for rectal cancer: comparison of 3D conformal radiotherapy and volumetric modulated arc therapy using different high dose fractionation schemes</title><author>Zwahlen, Daniel R ; Bischoff, Laura I ; Gruber, Günther ; Sumila, Marcin ; Schneider, Uwe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c494t-c78dc82576dc06a2f195a2210f801e46d060f60b7777ad1df971d05850b214ba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cancer</topic><topic>Care and treatment</topic><topic>Colorectal cancer</topic><topic>Diagnosis</topic><topic>Dose Fractionation</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasms, Radiation-Induced - epidemiology</topic><topic>Neoplasms, Second Primary - epidemiology</topic><topic>Organs at Risk - radiation effects</topic><topic>Patient outcomes</topic><topic>Prognosis</topic><topic>Radiotherapy</topic><topic>Radiotherapy Planning, Computer-Assisted</topic><topic>Radiotherapy, Conformal - adverse effects</topic><topic>Radiotherapy, Intensity-Modulated - adverse effects</topic><topic>Rectal Neoplasms - radiotherapy</topic><topic>Relapse</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zwahlen, Daniel R</creatorcontrib><creatorcontrib>Bischoff, Laura I</creatorcontrib><creatorcontrib>Gruber, Günther</creatorcontrib><creatorcontrib>Sumila, Marcin</creatorcontrib><creatorcontrib>Schneider, Uwe</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zwahlen, Daniel R</au><au>Bischoff, Laura I</au><au>Gruber, Günther</au><au>Sumila, Marcin</au><au>Schneider, Uwe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Estimation of second cancer risk after radiotherapy for rectal cancer: comparison of 3D conformal radiotherapy and volumetric modulated arc therapy using different high dose fractionation schemes</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2016-11-10</date><risdate>2016</risdate><volume>11</volume><issue>1</issue><spage>149</spage><pages>149-</pages><artnum>149</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>To investigate second cancer risk (SCR) comparing volumetric modulated arc therapy (VMAT) and 3D conformal radiotherapy (3DCRT) with different high dose fractionation schemes.
VMAT and 3DCRT virtual treatment plans for 25 patients previously treated with radiotherapy for rectal cancer were evaluated retrospectively. Doses prescribed were 25 × 1.8 Gy and 5 × 5 Gy, respectively. SCR was estimated using a carcinogenesis model and epidemiological data for carcinoma and sarcoma induction. SCR was determined by lifetime attributable risk (LAR).
Mean excess LAR was highest for organs adjacent to the PTV. Total LAR for VMAT and 3DCRT was 2.3-3.0 and 2.0-2.7 %, respectively. For 5 × 5 Gy, LAR was 1.4-1.9 % for VMAT and 1.2-1.6 % for 3DCRT. Organ-specific excess LAR was significantly higher for VMAT, and highest for bladder and colon. Size and shape of the PTV influenced SCR and was highest for age ≤ 40 years. For a patient with an additional lifetime risk of 60 years, LAR was 10 % for 25 × 1.8 Gy and 6 % for 5 × 5 Gy.
No statistically significant difference was detected in SCR using VMAT or 3DCRT. For bladder and colon, organ-specific excess LAR was statistically lower using 3DCRT, however the difference was small. Compared to epidemiological data, SCR was smaller when using a hypofractionated schedule. SCR was 2 % higher at normal life expectancy.
ClinicalTrials.gov Identifier NCT02572362 . Registered 4 October 2015. Retrospectively registered.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>27832799</pmid><doi>10.1186/s13014-016-0723-6</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | Radiation oncology (London, England), 2016-11, Vol.11 (1), p.149, Article 149 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Aged Aged, 80 and over Cancer Care and treatment Colorectal cancer Diagnosis Dose Fractionation Female Humans Male Middle Aged Neoplasms, Radiation-Induced - epidemiology Neoplasms, Second Primary - epidemiology Organs at Risk - radiation effects Patient outcomes Prognosis Radiotherapy Radiotherapy Planning, Computer-Assisted Radiotherapy, Conformal - adverse effects Radiotherapy, Intensity-Modulated - adverse effects Rectal Neoplasms - radiotherapy Relapse Retrospective Studies Risk Risk factors |
| title | Estimation of second cancer risk after radiotherapy for rectal cancer: comparison of 3D conformal radiotherapy and volumetric modulated arc therapy using different high dose fractionation schemes |
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