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Radiation Therapy for Invasive Breast Cancer Increases the Risk of Second Primary Lung Cancer: A Nationwide Population-Based Cohort Analysis Yi-Jhih Huang, MD, Tsai-Wang Huang, MD, Fu-Huang Lin, PhD, Chi-Hsiang Chung, PhD, Chang-Huei Tsao, PhD, Wu-Chien Chien, PhD Journal of Thoracic Oncology Volume 12, Issue 5, Pages (May 2017) DOI: /j.jtho Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions
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Figure 1 An algorithm of the study design and patient selection from the National Health Insurance Research Database. Breast cancer was defined as International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 174. Cancers of the trachea, bronchus, and lung were defined as ICD-9-CM code 162. Other cancers and carcinoma in situ were defined as ICD-9-CM codes 140 to 161, 163 to 173, and 175 to 239. Radiation therapy was defined as ICD-9-CM procedure code OP 92.2 combined with National Health Insurance order codes 36006B or 36009B for cobalt 60 teletherapy and 36011B or 36012B for linear accelerator teletherapy. Journal of Thoracic Oncology , DOI: ( /j.jtho ) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions
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Figure 2 Incidence of newly diagnosed second primary lung cancer after radiation therapy (RT) according to number of years of follow-up before diagnosis and a Kaplan-Meier curve of overall second primary lung cancer–specific disease-free survival. (A) In most of the individuals, second primary lung cancer was diagnosed within the first 3 years after RT. (B) Among females with breast cancer who were older than 18 years, disease-free survival of second primary lung cancer was stratified by RT using the log-rank test (p < 0.001). Journal of Thoracic Oncology , DOI: ( /j.jtho ) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions
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Figure 3 Kaplan-Meier for secondary primary lung cancer–specific disease-free survival among females with breast cancer aged 18 years or older stratified by radiation therapy and the different surgical options with the log-rank test. The second primary lung cancer–specific disease-free survival was shorter for those who underwent radiation therapy alone or mastectomy plus radiation therapy. Journal of Thoracic Oncology , DOI: ( /j.jtho ) Copyright © 2017 International Association for the Study of Lung Cancer Terms and Conditions
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