Secondary Cancer Risk after Radiotherapy of Seminoma Stage One

Document Type : Original Paper

Authors

1 Department of Radiology, Faculty of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran.

2 Department of Radiation Oncology, School of Medicine, Isfahan University of Medical Sciences. Isfahan, Iran,

3 Department of Medical Physics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.

4 Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

 
Introduction: In radiation treatment of stage one seminoma (SOS) induced secondary cancer in organs at risk (OARs), is late toxicity of major concern. This study aimed to compare the secondary cancer risk in radiotherapy of SOS in two-dimensional conventional (2D) radiation therapy and three-dimensional conformal radiation therapy (3DCRT).
Material and Methods: CT scan images of 10 patients with SOS were used to design 2D conventional and 3D conformal treatment plans using 25 Gy in 20 sessions. The life attributable risk (LAR) of the liver, stomach, and colon were calculated using the organ equivalent dose (OED) model for organs in the radiation field and the Biologic Effects of Ionizing Radiation VII (BEIR VII) model for organs out of the field.
Results: LAR of OARs in radiation fields such as the liver and stomach were obtained 40% higher in the 2D treatment than in the 3D treatment, while as for the colon, it was 17% lower in the 2D treatment than in the 3D treatment. The LAR values of kidneys located outside the radiation field in the 2D treatment were calculated at 0.04%.
Conclusion: Increasing the prescribed dose (25 vs. 20) as well as the number of treatment sessions (20 vs. 10) resulted in increase in the LAR of the liver, stomach, and colon. Therefore, estimating the cancer risk of critical organs exposed to radiation through examining the effects of dose fractionation and prescribed doses can be used in optimizing of the treatment plan for seminoma, selecting a better treatment method by oncologists, and patient follow-up.

Keywords

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References

  1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, CA: a cancer journal for clinicians. 2022 Jan 12.
  2. Halperin EC, Brady LW, Wazer DE, Perez CA. Perez & Brady's principles and practice of radiation oncology. Lippincott Williams & Wilkins; 2013 May 6.
  3. Lewinshtein D, Gulati R, Nelson PS, Porter CR. Incidence of second malignancies after external beam radiotherapy for clinical stage I testicular seminoma. British Journal of Urology. 2012, 109(5):706-12.
  4. Zwahlen DR, Martin JM, Millar JL, Schneider U. Effect of radiotherapy volume and dose on secondary cancer risk in stage I testicular seminoma. International Journal of Radiation Oncology Biology Physics. 2008.70(3):853-8.
  5. Chovanec M, Lauritsen J, Bandak M, Oing C, Kier GG, Kreiberg M, and et al. Late adverse effects and quality of life in survivors of testicular germ cell tumour. Nature Reviews Urology. 2021,18(4):227-45.
  6. Mazonakis M, Varveris C, Lyraraki E, Damilakis J. Radiotherapy for stage I seminoma of the testis: Organ equivalent dose to partially in‐field structures and second cancer risk estimates on the basis of a mechanistic, bell‐shaped, and plateau model. Medical physics. 2015, 42(11):6309-16.
  7. Pawel DJ, Puskin JS. US Environmental Protection Agency radiogenic risk models and projections for the US population. Health Physics. 2012, 102(6):646-56.
  8. Schneider U, Sumila M, Robotka J. Site-specific dose-response relationships for cancer induction from the combined Japanese A-bomb and Hodgkin cohorts for doses relevant to radiotherapy. Theoretical Biology and Medical Modelling. 2011, 8(1):1-21.
  9. Ruf CG, Isbarn H, Wagner W, Fisch M, Matthies C, Dieckmann K-P. Changes in epidemiologic features of testicular germ cell cancer: age at diagnosis and relative frequency of seminoma are constantly and significantly increasing. Urologic Oncology: Seminars and Original Investigations. 2014, 32(1): 31-31.
  10. Arias E. United States Life Tables. National Vital Statistics Reports; Vol. 59, no. 9. Hyattsville, MD: National Center for Health Statistics. 2011
  11. Zwahlen DR, Martin JM, Millar JL, Schneider U. Effect of radiotherapy volume and dose on secondary cancer risk in stage I testicular seminoma. International Journal of Radiation Oncology Biology Physics. 2008, 70(3):853-8
  12. Meier V, Staudinger C, Radonic S, Besserer J, Schneider U, Walsh L, and et al. Reducing margins for abdominopelvic tumors in dogs: impact on dose‐coverage and normal tissue complication probability. Veterinary and Comparative Oncology. 2021, 19(2):266–274
  13. De Rose F, Cozzi L, Meattini I, Fogliata A, Franceschini D, Franzese C. The Potential Role of Intensity-modulated Proton Therapy in the Regional Nodal Irradiation of Breast Cancer: A Treatment Planning Study. Clinical Oncology.2020, 32(1):26-34.
  14. Dobler B, Maier J, Knott B, Maerz M, Loeschel R, Koelbl O. Second cancer risk after simultaneous integrated boost radiation therapy of right sided breast cancer with and without flattening filter. Strahlentherapie und Onkologie. 2016, 192(10):687-95.
  15. Feng Z, Hao W, Tie J, Cheng J, Sun Q. Radiotherapy-induced secondary primary cancer risks for early breast cancer: flattening filter versus flattening filter free IMRT radiotherapy. Chinese Journal of Radiological Medicine and Protection. 2018, 38(3):210-4.
  16. Chao P-J, Lee H-F, Lan J-H, Guo S-S, Ting H-M, Huang Y-J, and et al. Propensity-score-matched evaluation of the incidence of radiation pneumonitis and secondary cancer risk for breast cancer patients treated with IMRT/VMAT. Scientific reports. 2017, 7(1):1-9.
  17. Haciislamoglu E, Cinar Y, Gurcan F, Canyilmaz E, Gungor G, Yoney A. Secondary cancer risk after whole-breast radiation therapy: field-in-field versus intensity modulated radiation therapy versus volumetric modulated arc therapy. The British journal of radiology. 2019, 92(1102):1-7.
  18. Ash P. The influence of radiation on fertility in man. The British journal of radiology. 1980, 53(628):271-8.
  19. De Felice F, Marchetti C, Marampon F, Cascialli G, Muzii L, Tombolini V. Radiation effects on male fertility. Andrology. 2019, 7(1):2-7.
  20. Horwich A, Fossa SD, Huddart R, Dearnaley D, Stenning S, Aresu M, et al. Second cancer risk and mortality in men treated with radiotherapy for stage I seminoma. British journal of cancer. 2014, 110(1):256-63.
  21. Hauptmann M, Fossa SD, Stovall M, Van Leeuwen FE, Johannesen TB, Rajaraman P, Gilbert ES, Smith SA, Weathers RE, Aleman BM, Andersson M. Increased stomach cancer risk following radiotherapy for testicular cancer. British journal of cancer. 2015 Jan;112(1):44-51.
  22. Schneider U, Kaser-Hotz B. Radiation risk estimates after radiotherapy: application of the organ equivalent dose concept to plateau dose–response relationships. Radiation and environmental biophysics. 2005, 44(3):235-9.

 

 

 

 

Iranian Journal of Medical Physics
Volume 19, Issue 3
May and June 2022
Pages 175-180

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History

  • Receive Date: 30 May 2021
  • Revise Date: 29 October 2021
  • Accept Date: 11 November 2021

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