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Assessment of Normal Tissue Complications and Second Cancer Risks Following Prostate Cancer Irradiation: A Review

Issue: Vol.7, No.3 - July 2008

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Article Type: Manuscript

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  1. Dr Rungdham Takam
    Medical Physics Department, Royal Adelaide Hospital
  2. Eva Bezak
  3. Eric Yeoh
  4. Loredana Marcu

There are various radiotherapy modalities that can be chosen for treatment of prostate cancer. The main therapeutic aim of all radiotherapy treatment including prostate is to maximize damage to the tumour and, at the same time, damaging of the surrounding normal tissues must be kept as small as possible. During a process of treatment planning, Tumour Control Probability (TCP) and Normal Tissue Complication Probability (NTCP) are usually assessed to maximize the therapeutic ratio of that treatment modality. However, there is another factor which should also be taken into consideration when the radiotherapy is used for prostate treatment: the risk of developing a fatal second (primary) cancer. There is a number of reports that indicated an elevation in the risk of second cancer of various organs following prostate cancer irradiation, for example, lung, bladder, skin and breast. It was reported in literature that approximately 6 - 7% of prostate cancer patients might develop second cancer following radiotherapy. Although results from some retrospective studies showed that the incidence of second cancers in prostate cancer patients who received radiation treatment is lower than or equal to the baseline, the risk of developing a second cancer in some organs has been significantly elevated. This risk, in association with each available treatment modality for prostate cancer, has not been investigated to this date thoroughly. This review intends to demonstrate such association as found in various reports and also to show a possible approach to assess this risk.

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