Review Article Outline

Secondary Malignancies Following Radiation Therapy

Abstract

Around 40% of the population will receive a cancer diagnosis at some point in their lifetime, and of those patients, 50% will receive radiation therapy as part of their care. Radiation therapy can be implemented in the definitive setting with curative intent or in the palliative setting to alleviate symptoms. Although integral in care, there are long-term risks after radiation therapy, namely the low likelihood of developing a secondary malignancy. This risk is small, much less than 1%; however, can be consequential. Established risk factors such as age at the time of treatment, gender, and radiation technique are important factors when calculating an individual's risk. To mitigate the likelihood of secondary malignancy, several strategies such as choice of radiation technique (i.e., protons, MRI-guided radiation therapy) and decreased frequency of on-board imaging can be considered. Importantly, patient and provider education regarding changes in cancer screening to detect secondary malignancies at an early stage are critical. Secondary malignancies following radiation therapy are rare; but recognizing the risk factors and strategies to mitigate these risks can prevent patients from experiencing this serious iatrogenic complication.