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Does yttrium radiosynovectomy increase the risk of cancer in patients with rheumatoid arthritis?
  1. J Vuorela1,
  2. T Sokka2,
  3. E Pukkala4,
  4. P Hannonen3
  1. 1Hospital Physics, Jyväskylä Central Hospital, Jyväskylä, Finland
  2. 2Department of Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland and Vanderbilt University, Nashville, TN, USA
  3. 3Department of Medicine, Jyväskylä Central Hospital, Jyväskylä, Finland
  4. 4Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
  1. Correspondence to:
    Dr T Sokka, Vanderbilt University/Rheumatology, 203 Oxford House, Nashville TN 37232–4500, USA;
    tuulikki.sokka{at}vanderbilt.edu

Abstract

Objective: To study the long term risk of cancer in patients with rheumatoid arthritis (RA) who have been treated with yttrium.

Methods: The medical record numbers of 1228 patients with RA who were admitted to hospital in 1979–85 were identified in the database of Jyväskylä Central Hospital. Radiosynovectomy of the knee joint was performed in a total of 143 patients using yttrium-90 silicate during the years 1970–85, while 1075 did not receive yttrium radiosynovectomy; 10 received yttrium treatment later than 1985 and were excluded from the analysis. The Finnish Cancer Registry database was used to examine whether the subjects had cancer during the follow up from 1979 until the end of 1999.

Results: Nine cases of cancer were found among the patients who had received yttrium, whereas the expected number based on the incidence among the population in the region was 14.9. The standardised incidence ratio of cancer was 0.6 (95% confidence interval (CI) 0.3 to 1.1) for the patients who received yttrium, and 1.1 (95% CI 0.9 to 1.3) for the patients who did not receive yttrium.

Conclusions: Yttrium treatment did not increase the risk of cancer.

  • rheumatoid arthritisp
  • yttrium synovectomy
  • CI, confidence interval
  • RA, rheumatoid arthritis
  • SIR, standardised incidence ratio

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