Estimation of the carcinogenic risk of radiotherapy of benign diseases from shoulder to heel

Jansen, Jan; Broerse, J.J.; Zoetelief, J.; Klein, Claudia; Seegenschmiedt, Heinrich

doi:10.1016/j.radonc.2005.06.034

Cited by 65 publications

(38 citation statements)

References 13 publications

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“…However, a useful recent study of both male and female anthropomorphic phantoms has demonstrated the long-term risks of RIC in patients treated with modern RT protocols for a range of benign diseases (heterotopic ossification, arthritis of the shoulder or knee joints, heel spurs and hidradenitis suppurativa). 46 The risk of RIC was calculated using the International Commission on Radiological Protection recommendation of the average carcinogenic risk resulting from radiation exposure, which was estimated to be 10%/Sv for high dose and high-dose rate exposure to ionizing radiation (IR). 47 The authors discussed in some detail the basis of the assumptions which indicated that when using RT to treat these conditions, the effective dose range was 5-400 mSv, providing a prediction of an increase in RICs of 0.5-40/1000 patients treated.…”

Section: Studies Providing Indirect Evidence Of the Excess Risk Of Ramentioning

confidence: 99%

Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation

McKeown

Hatfield

Prestwich

et al. 2015

BJR

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Most radiotherapy (RT) involves the use of high doses (.50 Gy) to treat malignant disease. However, low to intermediate doses (approximately 3-50 Gy) can provide effective control of a number of benign conditions, ranging from inflammatory/proliferative disorders (e.g. Dupuytren's disease, heterotopic ossification, keloid scarring, pigmented villonodular synovitis) to benign tumours (e.g. glomus tumours or juvenile nasopharyngeal angiofibromas). Current use in UK RT departments is very variable. This review identifies those benign diseases for which RT provides good control of symptoms with, for the most part, minimal side effects. However, exposure to radiation has the potential to cause a radiation-induced cancer (RIC) many years after treatment. The evidence for the magnitude of this risk comes from many disparate sources and is constrained by the small number of long-term studies in relevant clinical cohorts. This review considers the types of evidence available, i.e. theoretical models, phantom studies, epidemiological studies, longterm follow-up of cancer patients and those treated for benign disease, although many of the latter data pertain to treatments that are no longer used. Informative studies are summarized and considered in relation to the potential for development of a RIC in a range of key tissues (skin, brain etc.). Overall, the evidence suggests that the risks of cancer following RT for benign disease for currently advised protocols are small, especially in older patients. However, the balance of risk vs benefit needs to be considered in younger adults and especially if RT is being considered in adolescents or children.

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Section: Studies Providing Indirect Evidence Of the Excess Risk Of Ramentioning

confidence: 99%

Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation

McKeown

Hatfield

Prestwich

et al. 2015

BJR

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“…Jansen et al calculated for 6 × 0.5 Gy about 1.5 mSv received by the testes and 0.75 mSv to the ovaries [46]. Comparable results have repeatedly been measured in the past [47,48].…”

Section: Impairment Of Gonad Functionmentioning

confidence: 54%

“…The risk is already reduced in the 3rd decade of the patient's life, it starts to decrease steadily from the age of 40 [60]. Applying these calculations, the estimated lifetime risk per one thousand patients for a fatal tumor accounts for the age of 25 0.6 (male)/0.8 (female), for the age of 50 0.2/0.3, for the age of 75 0.07/0.1 [46].…”

Section: Induction Of Malignanciesmentioning

confidence: 98%

“…As the distal extremity is irradiated, scattered dose to the gonads is comparable to normal diagnostic radiological imaging [49]. The hereditary effects of these doses are very small and very likely negligible [46].…”

Section: Impairment Of Gonad Functionmentioning

confidence: 99%

“…Jansen et al applied the ICRP model on LD-EBRT of a painful heel spur [46]. Assumed was a single field entering at the foot sole with a size of 8 × 10 cm, 200 kV photons, SSD 40 cm.…”

Section: Induction Of Malignanciesmentioning

confidence: 99%

See 2 more Smart Citations

Low-Dose Radiotherapy of Painful Heel Spur/Plantar Fasciitis as an Example of Treatment Effects in Benign Diseases

Hermann¹,

Bruns²,

Nitsche³

2017

Radiotherapy

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Degenerative changes in the plantar fascia may cause the so-called "painful heel" with typical projections of tenderness. This condition is often associated with a plantar heel spur. Radiotherapy with low doses (LD-EBRT) has been well known for its anti-inflammatory potential. In the recent years, several microbiological mechanisms were elucidated to explain immunomodulation by LD-EBRT. Furthermore, a randomized study proved the clinical efficacy of this therapy in plantar fasciitis. Two other trials defined a fractionation schedule of 6 × 0.5 Gy twice weekly as the new standard therapy. Taken together, LD-EBRT is an effective and safe therapeutic option for patients over 30 years of age and after exclusion of pregnancy. In case of an insufficient response, a second course can be offered to the patient. There are still open questions concerning target volume definition and fractionation of LD-EBRT. Furthermore, studies randomizing LD-EBRT with other conservative therapeutic approaches are missing.

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Estimating the Risk of Radiation-Induced Malignancy Following Radiotherapy for Benign Disease

Nakamura¹,

Braunstein²,

McKeown³

2022

Medical Radiology

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Estimation of the carcinogenic risk of radiotherapy of benign diseases from shoulder to heel

Cited by 65 publications

References 13 publications

Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation

Radiotherapy for benign disease; assessing the risk of radiation-induced cancer following exposure to intermediate dose radiation

Low-Dose Radiotherapy of Painful Heel Spur/Plantar Fasciitis as an Example of Treatment Effects in Benign Diseases

Estimating the Risk of Radiation-Induced Malignancy Following Radiotherapy for Benign Disease

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