Whether pelvic radiotherapy increased the risk of secondary bladder cancer? A systematic review and meta-analysis
Bibliographic record
Abstract
Abstract Background The question whether pelvic radiotherapy increases the risk of secondary bladder cancer remains unclear. In this review, we aimed to demonstrate the relationship between exposure to radiation therapy for pelvic malignancies and subsequent second primary bladder cancer risk. Methods We systematically searched Medline, Embase and Web of Science for all associated studies concerning secondary bladder cancer risk and radiotherapy for primary pelvic cancers up to 15 th December 2019. We extracted related study characteristics and outcomes. Risk of bias was assessed by the Newcastle-Ottawa Scale. Outcomes were synthesized with random effect models and Manhtel-Haenszel weighting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational studies in Epidemiology (MOOSE) guidelines were used for reporting this systematic review and meta-analysis. We use GRADE system to assess the quality of main outcome. Results We identified 3958 references after literature searching and eventually 19 studies were selected for meta-analysis. Most studies were cohort studies with moderate risk of bias. Compared with patients treated without radiotherapy, our results showed an increased risk of secondary bladder cancer after radiotherapy for pelvic malignancies (RR 1.75,95% Confidence Interval [CI] 1.50-2.05) with moderate quality of evidence. Similar results were also found in organ-specific analysis of radiation therapy for testicular cancer(RR 2.25,95% CI 1.34-3.78),uterine cancer(RR 2.52,95%CI 1.12-5.67) and prostate cancer(RR 1.64 95%CI 1.39-1.93).Although a varied definitions of latency periods used in different studies, the results showed a consistently increased risk of bladder cancer in all analyzed latency periods, and lag time over 10 years ranked as the highest relative risk(RR 2.98,95%CI 1.88-4.71). When compared with no radiotherapy, EBRT and Any RT significantly increased the risk of second primary bladder cancer (RR 2.08,95%CI 1.67-2.61 and RR 1.77,95%CI 1.49-2.10), but not for BT group (RR 1.58,95%CI 0.98-2.55). Conclusion In conclusion, pelvic radiotherapy was associated with higher relative risk of secondary bladder cancer compared with those without radiotherapy. These findings may help outpatient counseling and early detection of secondary cancer after diagnosis and treatment of first primary cancer. Keywords: Secondary Bladder cancer, Pelvic malignancies, Radiotherapy, Meta-analysis
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.052 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.023 | 0.044 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".