{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T19:21:26Z","timestamp":1773084086205,"version":"3.50.1"},"reference-count":49,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T00:00:00Z","timestamp":1739318400000},"content-version":"unspecified","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,1,27]]},"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to assess the association between adjuvant radiotherapy and the development of second primary malignancies (SPMs) and identify its determinants in patients who have undergone surgical treatment for gastric cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study using the Surveillance, Epidemiology and End Results (SEER) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Cohorts (18 registries, 2000\u20132018, from SEER) were screened for any malignancy that developed after sufficient latency from diagnosis of surgically treated non-metastatic gastric cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>24\u2009777 surgically treated gastric cancer cases were included in the cohort. Among them, 6128 patients underwent adjuvant radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The cumulative incidence of SPMs was estimated using Fine and Gray\u2019s competing risk model and the radiotherapy-correlated risks were calculated using Poisson regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among patients with sufficient latency, there was no significant association between radiotherapy and the risk of developing second primary solid malignancies (relative risk=1.05, 95%\u2009CI 0.83 to 1.33) or haematological malignancies (relative risk=1.17, 95%\u2009CI 0.62 to 2.11). Interestingly, radiotherapy was associated with a reduced cumulative incidence of second lung and bronchus cancer compared with no radiotherapy, with a 15-year incidence of 1.4%\u20133.17% (p&lt;0.05). Radiotherapy was not associated with a significant increase in standardised incidence ratios of SPMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjuvant radiotherapy was not associated with an increased risk of developing SPMs in surgically treated patients with gastric cancer. Clinical trials are warranted to further verify the findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086349","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T13:11:13Z","timestamp":1739365873000},"page":"e086349","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Association between adjuvant radiotherapy in adults with gastric cancer and risk of second primary malignancy: a retrospective cohort study using the Surveillance, Epidemiology and End Results database"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4415-6552","authenticated-orcid":false,"given":"Zheng","family":"Li","sequence":"first","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zefeng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chongyuan","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaojie","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"He","family":"Fei","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Beijing Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongbing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center\/ National Clinical Research for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,2,12]]},"reference":[{"key":"2025121223043277000_15.2.e086349.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"2025121223043277000_15.2.e086349.2","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-016-0622-4"},{"key":"2025121223043277000_15.2.e086349.3","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27550"},{"key":"2025121223043277000_15.2.e086349.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055531"},{"key":"2025121223043277000_15.2.e086349.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.26.6114"},{"key":"2025121223043277000_15.2.e086349.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa010187"},{"key":"2025121223043277000_15.2.e086349.7","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1245\/s10434-014-4032-8","article-title":"Does adjuvant chemoradiotherapy improve the prognosis of gastric cancer after an r1 resection? 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