Second malignant neoplasms and cardiovascular disease following radiotherapy
Abstract
Advances in cancer therapy, early detection, and supportive care have contributed to steady gains in the 5-year relative survival rate for all cancers combined, which reached 66.0% for patients diagnosed during 1999-2006 (1).Commensurately, the number of cancer survivors in the United States has tripled since 1971 and is growing by 2% each year.As of 2007, there were approximately 12 million men and women in the United States-approximately 3.5% of the US population-with a history of cancer (1).For many patients, these gains in survival have come at the price of serious treatment-associated late adverse effects.Radiation remains a cornerstone of successful cancer treatment, with 50% of all patients estimated to receive radiotherapy (2).Second malignant neoplasms (SMNs) and cardiovascular disease (CVD) are two of the most frequent and important life-threatening adverse events associated with radiotherapy.Multiple primary cancers now account for approximately one in six of all incident cancers reported to the US Surveillance, Epidemiology, and End Results Program cancer registry (1).For patients with Hodgkin lymphoma (3), testicular cancer (4,5), and certain childhood cancers (6), SMNs have emerged as an important cause of death (7).Radiotherapy-associated CVD refers to a wide spectrum of disorders and is an important cause of morbidity and mortality, most notably after thoracic radiotherapy for Hodgkin lymphoma and tangential radiotherapy for breast cancer (8,9).With the…
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