Guidelines for Complications of Cancer Treatment Vol VIII Part B

adiation dose, and age at treatment (12-16 years). Usinglogistic regression, mantle radiation dose increased risk, andthis was 2.5-fold for female patients treated with more than35 Gy primarily because of breast cancer. CONCLUSIONS:Survivors of childhood HD are at risk for SMNs, and this riskis greater for female individuals even after accounting forbreast cancer. Although SMNs occur in the absence of radiationtherapy, the risk increases with RT dose.3. Rusthoven K, Chen C, Raben D, et al: Use of externalbeam radiotherapy is associated with reduced incidenceof second primary head and neck cancer: a SEERdatabase analysisInt J Radiat Oncol Biol Phys 2008;71(1):192-198PURPOSE: Patients with head and neck cancer have asignificant risk of developing a second primary cancer of thehead and neck. We hypothesized that treatment with externalbeam radiotherapy (RT) might reduce this risk, because RTcan eradicate occult foci of second head and neck cancer(HNCA).METHODS AND MATERIALS: The data of patients withSurveillance, Epidemiology, and End Results Historic StageA localized squamous cell carcinoma of the oral cavity, larynx,and pharynx were queried using the Surveillance,Epidemiology, and End Results database. For patients treatedwith or without RT, the incidence of second HNCA wasdetermined and compared using the log-rank method. Coxproportional hazards analysis was performed for each site,evaluating the influence of covariates on the risk of secondHNCA.RESULTS: Between 1973 and 1997, 27,985 patients wereentered with localized HNCA. Of these patients, 44% hadreceived RT and 56% had not. The 15-year incidence of secondHNCA was 7.7% with RT vs. 10.5% without RT (hazard ratio294