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Type: Journal article
Title: Risk of second primary cancer following prostate cancer radiotherapy: DVH analysis using the competitive risk model
Author: Takam, R.
Bezak, E.
Yeoh, E.
Citation: Physics in Medicine and Biology, 2009; 54(3):611-625
Publisher: IOP Publishing Ltd
Issue Date: 2009
ISSN: 0031-9155
Statement of
R. Takam, E. Bezak and E. E. Yeoh
Abstract: This study aimed to estimate the risk of developing second primary cancer (SPC) corresponding to various radiation treatment techniques for prostate cancer. Estimation of SPC was done by analysing differential dose–volume histograms (DDVH) of normal tissues such as rectum, bladder and urethra with the competitive risk model. Differential DVHs were obtained from treatment planning systems for external beam radiotherapy (EBRT), low-dose-rate (LDR) and high-dose-rate (HDR) brachytherapy techniques. The average risk of developing SPC was no greater than 0.6% for all treatment techniques but was lower with either LDR or HDR brachytherapy alone compared with any EBRT technique. For LDR and HDR brachytherapy alone, the risk of SPC for the rectum was 2.0 × 10−4% and 8.3 × 10−5% respectively compared with 0.2% for EBRT using five-field 3D-CRT to a total dose of 74 Gy. Overall, the risk of developing SPC for urethra following all radiation treatment techniques was very low compared with the rectum and bladder. Treatment plans which deliver equivalent doses of around 3–5 Gy to normal tissues were associated with higher risks of development of SPC.
Keywords: Humans
Prostatic Neoplasms
Neoplasms, Radiation-Induced
Neoplasms, Second Primary
Proportional Hazards Models
Risk Assessment
Risk Factors
DOI: 10.1088/0031-9155/54/3/009
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Chemistry and Physics publications

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