autor: zosia bluszcz » 27 sty 2018, 02:51
Bladder Cancer After Radiotherapy for Prostate Cancer
The radiation-related secondary primary malignancy risk increases with increasing survival time.
=> Previous radiotherapy (RT) for prostate cancer (PCa) may play an important role in the development of secondary primary bladder cancer.
This is a fairly uncommon event but a very real entity that both urologists and radiation oncologists need to be aware of.
=> Only two-dimensional RT was associated with a significantly higher risk, whereas the newer RT techniques (brachytherapy, brachytherapy boost, three-dimensional conformal RT [3 DCRT]/intensity-modulated RT [IMRT]) significantly reduced the risk.
=> The risk increases as a function of the time after irradiation.
The data we have analyzed show a significant increased risk after at least five years following irradiation, 15% after more than five years, and 34% after 10 years
=> Some patients treated for localized PCa will subsequently develop invasive bladder cancer requiring surgical intervention.
=> Gross hematuria is the first sign of bladder cancer and is often due to radiation cystitis.
This leads to a significantly longer latency period for the diagnosis of bladder cancer.
=> Transitional cell carcinoma of the bladder is the most frequent secondary primary malignancy occurring after radiotherapy and is described as more aggressive; it may be diagnosed later because some radiation oncologists believe that the hematuria that occurs after prostate EBRT is normal.
=> Several researchers suggest that bladder cancer diagnosed in patients treated with RT for PCa may be more aggressive than bladder cancer without previous prostate irradiation
=> Due to the increased risk for developing bladder cancer after pelvis irradiation, it is advisable to supervise patients who undergo RT for the treatment of PCa.
We propose a close follow-up with cystoscopy each year or every 6 months on the basis of existing comorbidities, as well as additional work-up and increased screening sampling density.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3821989/
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