Abstracts Archive

UK & Ireland Prostate Brachytherapy Conference 2012

Abstract number 3

The risk of second cancers occurring more than 5 years after I-125 monotherapy for early prostate cancer. 

A. Henry, H. B. Musunuru, M. Mason, D. Bottomley, K. Franks, P. Bownes, B. al-Qaisieh, B. Carey, J. Smith
St James’s Institute of Oncology, Leeds, United Kingdom
R. Tatarek-Gintowt
Northern and Yorkshire Cancer Registry and Information Service, Leeds, United Kingdom

Purpose: Prostate brachytherapy may be associated with a lower risk of radiation induced second primary cancer as a significantly smaller volume of normal tissue is irradiated when compared to external beam techniques. Limited data is available as it has been a routine treatment option for less than 20 years. This work identifies cases of second primary cancers (SPCs) in patients who underwent I-125 prostate brachytherapy in a single institution.

Methods: SPC incidence was retrieved by conducting UK cancer registry search (NYCRIS) for 1805 patients with localised prostate cancer who received monotherapy with I-125 brachytherapy from 1995 to 2005.The completeness of registry search was 91% .All patients had a minimum follow up of 6 years with the maximum being 17 years.

Results: A total of 201(11.1%) patients were diagnosed with SPCs arising at any site in the body (table 1). Of these patients 11 (5.47%) developed rectal cancer and 21(10.4%) developed bladder cancer. In our study the median time to develop bladder and rectal cancers was 4.2 and 4.7 years respectively. Only 3 out of 21 patients who developed bladder cancer and one out of 11 with rectal cancer (sarcoma) subsequently died from their SPC.

Conclusion: Overall the incidence of SPC following I-125 in our cohort is comparable to other published data with no significant excess > 5 years from treatment. The likelihood of mortality secondary to SPC of the bladder or rectum is unusual.