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This study aimed to evaluate the long-term incidence of secondary primary tumors (SPTs) following LDR-BT in Japanese patients with localized PCa and identify predictive factors associated with SPTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and materials<\/jats:title>\n                    <jats:p>We retrospectively reviewed the clinical records of 478 consecutive patients with localized PCa who underwent LDR-BT at the Gifu University Hospital. This study\u2019s primary endpoint was SPTs incidence, including bladder and rectal\/anal cancers. The secondary endpoint was the identification of risk factors for LDR-BT that predicted SPTs development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After a median follow-up period of 105\u00a0months, SPTs developed in 13 patients (2.7%). Bladder cancer and rectal\/anal canal cancer were observed in seven (1.5%) and six (1.3%) patients, respectively. Multivariate analysis showed that a biologically effective dose (BED)\u2009\u2265\u2009197\u00a0Gy was associated with increased risk of SPTs (hazard ratio 4.145; 95% confidence interval 1.108\u201315.498;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of SPTs following LDR-BT was relatively low. In multivariate analysis, BED\u2009\u2265\u2009197\u00a0Gy may be associated with an increased risk of SPT occurrence. Adequate tumor control can be achieved through appropriate radiation dose administration; carefully planned long-term follow-up may be beneficial for SPTs early detection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10147-026-03020-3","type":"journal-article","created":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T08:48:42Z","timestamp":1774774122000},"page":"1008-1016","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Secondary primary tumors following iodine-125 low-dose-rate brachytherapy for localized prostate cancer"],"prefix":"10.1007","volume":"31","author":[{"given":"Kojiro","family":"Niwa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0362-8624","authenticated-orcid":false,"given":"Koji","family":"Iinuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Nakano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Tomioka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Ito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayuki","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Kawase","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoki","family":"Taniguchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Tobisawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keita","family":"Nakane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Matsuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Koie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,29]]},"reference":[{"key":"3020_CR1","unstructured":"International Agency for Research on Cancer. 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