{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T03:05:26Z","timestamp":1784430326896,"version":"3.55.0"},"reference-count":25,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"15","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2015,5,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> This study investigated the long-term probability of developing a second cancer in a large pooled cohort of patients treated with surgery with or without radiotherapy (RT). <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> All second cancers diagnosed in patients included in the TME, PORTEC-1, and PORTEC-2 trials were analyzed. In the TME trial, patients with rectal cancer (n = 1,530) were randomly allocated to preoperative external-beam RT (EBRT; 25 Gy in five fractions) or no RT. In the PORTEC trials, patients with endometrial cancer were randomly assigned to postoperative EBRT (46 Gy in 2-Gy fractions) versus no RT (PORTEC-1; n = 714) or EBRT versus vaginal brachytherapy (VBT; PORTEC-2; n = 427). <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> A total of 2,554 patients were analyzed (median follow-up, 13.0 years; range 1.8 to 21.2 years). No differences were found in second cancer probability between patients who were treated without RT (10- and 15-year rates, 15.8% and 26.5%, respectively) and those treated with EBRT (10- and 15-year rates, 15.4% and 25.6%, respectively) or VBT (10-year rate, 14.9%). In the individual trials, no significant differences were found between treatment arms. All cancer survivors had a higher risk of developing a second cancer compared with an age- and sex-matched general population. The standardized incidence ratio for any second cancer was 2.98 (95% CI, 2.82 to 3.14). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> In this pooled trial cohort of &gt; 2,500 patients with pelvic cancers, those who underwent EBRT or VBT had no higher probability of developing a second cancer than patients who were treated with surgery alone. However, patients with rectal or endometrial cancer had an increased probability of developing a second cancer compared with the general population. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2014.58.6693","type":"journal-article","created":{"date-parts":[[2014,12,23]],"date-time":"2014-12-23T06:51:59Z","timestamp":1419317519000},"page":"1640-1646","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":88,"title":["No Increased Risk of Second Cancer After Radiotherapy in Patients Treated for Rectal or Endometrial Cancer in the Randomized TME, PORTEC-1, and PORTEC-2 Trials"],"prefix":"10.1200","volume":"33","author":[{"given":"Lisette M.","family":"Wiltink","sequence":"first","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. Rutten, Catharina Hospital Eindhoven, Eindhoven, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remi A.","family":"Nout","sequence":"additional","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. Rutten, Catharina Hospital Eindhoven, Eindhoven, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Fiocco","sequence":"additional","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. Rutten, Catharina Hospital Eindhoven, Eindhoven, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elma","family":"Meershoek-Klein Kranenbarg","sequence":"additional","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. Rutten, Catharina Hospital Eindhoven, Eindhoven, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ina M.","family":"J\u00fcrgenliemk-Schulz","sequence":"additional","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. 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Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. Rutten, Catharina Hospital Eindhoven, Eindhoven, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harm J.T.","family":"Rutten","sequence":"additional","affiliation":[{"name":"Lisette M. Wiltink, Remi A. Nout, Marta Fiocco, Elma Meershoek-Klein Kranenbarg, Cornelis J.H. van de Velde, Carien L. Creutzberg, and Corrie A.M. Marijnen, Leiden University Medical Center, Leiden; Ina M. J\u00fcrgenliemk-Schulz, University Medical Center Utrecht, Utrecht; Jan J. Jobsen, Medisch Spectum Twente, Enschede; Iris D. Nagtegaal, Radboud University Medical Center, Nijmegen; and Harm J.T. 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