Solid Cancer Incidence in Atomic Bomb Survivors: 1958–1998

Preston, Dale L.; Ron, Elaine; Tokuoka, Shoji; Funamoto, Sachiyo; Nishi, Nobuo; Soda, Midori; Mabuchi, Kiyóhiko; Kodama, Kazunori

doi:10.1667/rr0763.1

Cited by 1,525 publications

(1,470 citation statements)

References 99 publications

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“…In the low‐dose region, the EAR presents a linear dose–response 19, 20. Since planning CT data do not include images at larger distances for reasons of radiation protection, no calculations of the EAR based on DVH are possible, for example, bladder, bowel, and gonads.…”

Section: Methodsmentioning

confidence: 99%

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Second cancer risk after radiation therapy of ependymoma using the flattening filter free irradiation mode of a linear accelerator

Moret

Obermeier

Pohl

et al. 2018

J Applied Clin Med Phys

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Pediatric patients suffering from ependymoma are usually treated with cranial or craniospinal three‐dimensional (3D) conformal radiotherapy (3DCRT). Intensity‐modulated techniques spare dose to the surrounding tissue, but the risk for second malignancies may be increased due to the increase in low‐dose volume. The aim of this study is to investigate if the flattening filter free (FFF) mode allows reducing the risk for second malignancies compared to the mode with flattening filter (FF) for intensity‐modulated techniques and to 3DCRT. A reduction of the risk would be advantageous for treating pediatric ependymoma. 3DCRT was compared to intensity‐modulated radiation therapy (IMRT) and volumetric‐modulated arc therapy (VMAT) with and without flattening filter. Dose–volume histograms (DVHs) were compared to evaluate the plan quality and used to calculate the excess absolute risk (EAR) to develop second cancer in the brain. Dose verification was performed with a two‐dimensional (2D) ionization chamber array and the out‐of‐field dose was measured with an ionization chamber to determine the EAR in peripheral organs. Delivery times were measured. Both VMAT and IMRT achieved similar plan quality in terms of dose sparing in the OAR and higher PTV coverage as compared to 3DCRT. Peripheral dose in low‐dose region, which is proportional to the EAR in organs located in this region, for example, gonads, bladder, or bowel, could be significantly reduced using FFF. The lowest peripheral EAR and lowest delivery times were hereby achieved with VMATFFF. The EAR calculated based on DVH in the brain could not be reduced using FFF mode. VMATFFF improved the target coverage and homogeneity and kept the dose in the OAR similar compared to 3DCRT. In addition, delivery times were significantly reduced using VMATFFF. Therefore, for radiotherapy of ependymoma patients, VMATFFF may be considered advantageous for the combination of Elekta Synergy linac and Oncentra External Beam planning system used in this study.

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Section: Methodsmentioning

confidence: 99%

“…EAR 0 , γ e , and γ a values have been derived by Preston et al 20. from the data of the Japanese atomic bomb survivors (EAR 0 = 0.7 per 10,000 person‐years per Gy for the brain, γ e = −0.024, and γ a = 2.38).…”

Section: Methodsmentioning

confidence: 99%

Second cancer risk after radiation therapy of ependymoma using the flattening filter free irradiation mode of a linear accelerator

Moret

Obermeier

Pohl

et al. 2018

J Applied Clin Med Phys

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“…Thyroid cancer rates were observed to increase in children exposed to the atomic blasts in Japan [15].The latency period between the time of radiation exposure and cancer onset in children is typically 10-20 years [14]. More than 5,000 children developed DTC after radiation exposure after the nuclear reactor explosion tragedy at Chernobyl in 1986 [16].…”

Section: Risk Factors For Thyroid Cancer In Childrenmentioning

confidence: 99%

Pediatric Thyroid Cancers: An Indian Perspective

Chaukar

Vaidya

2012

Indian J Surg Oncol

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Pediatric thyroid cancer is a rare entity accounting for less than 5% of all thyroid cancers. This intriguing disease is characterized by advanced presentation, coupled with frequent lymph nodal metastases and often pulmonary metastases. It perhaps exhibits a distinct biology and behaviour, because in spite of its aggressiveness, survival is extremely good. This mandates meticulous treatment decisions that are well executed, because the complications of therapy in patients with good survival may spell prolonged morbidity. Being an unusual disease, it is unlikely that level I evidence guiding the management will come forth. There have been controversies regarding management, and the current consensus comes from large prospective studies. There have been only a few studies from India detailing pediatric thyroid cancers. In the current discussion, we review the existing evidence about pediatric thyroid cancers, and try to have an Indian perspective at the problem.

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“…Congruent with our nonlinear findings, Preston et al, in an analysis of 42,902 men who were atomic bomb survivors, discovered that exposure to 0.5 to 1.0 grays had a parabolic-shaped relative risk curve (an inverted ''U'') with the peak incidence rate observed among men who were exposed at ages 20 to 29 years. 20 In fact, in a recent analysis of observed cancer risk patterns as a function of age at exposure in Japanese atomic bomb survivors, Brenner and colleagues described 2 separate processes that contribute to radiation-induced carcinogenesis 21 : the first is initiation, ie, the induction of irreversibly altered premalignant cells, such as mutation to an oncogene, and the second is radiation-induced promotion, ie, the process by which an initiated cell expands with a pursuant increase in the average number of premalignant stem cells per clone. Hence, whereas initiation effects are expected to be the primary factor in carcinogenic among younger patients, it is promotion that facilitates development of a radiation-induced malignancy in older adults.…”

Section: Discussionmentioning

confidence: 99%

Secondary malignancies among nonseminomatous germ cell tumor cancer survivors

Chamie

Kurzrock

Evans

et al. 2011

Cancer

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BACKGROUND: Men on active surveillance for clinical stage I nonseminomatous germ cell tumor (NSGCT) undergo frequent computed tomography imaging to avoid delayed detection of disease. Irradiation from frequent imaging and chemotherapy upon progression may place patients at increased risk of a second malignancy. In this study, the authors sought to identify such an increased risk among men who chose initial surveillance for NSGCT. METHODS: The authors utilized data from the Surveillance, Epidemiology and End Results Program and stratified the cohort based on whether they underwent retroperitoneal lymph node dissection (RPLND). A propensity-score model was used to adjust for covariates, and a competing-risks regression analysis was performed to estimate cumulative incidence rates of second malignancy. Incidence risk ratios were predicted by using the cumulative incidence rates per 10,000 patients. RESULTS: There was no statistically significant increase in the incidence of a secondary malignancy for the entire cohort of testicular cancer survivors. However, when the analysis was restricted to patients with clinical stage I NSGCT, nonsurgical management only in those aged >45 years was an independent predictor of developing a second malignancy. For every 10,000 patients with stage I NSGCT who chose to forego RPLND, an absolute excess incidence of 22, 52, and 73 secondary malignancies would be diagnosed at 5 years, 10 years, and 15 years, respectively. CONCLUSIONS: The current results indicated that patients aged >45 years who forego RPLND for T1 or T2 clinical stage I NSGCT are more likely to develop a second malignancy than those who do undergo RPLND. Nonsurgical management of NSGCT may be associated with more long-term health risks than primary RPLND. Cancer 2011;117:4219-30.

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Solid Cancer Incidence in Atomic Bomb Survivors: 1958–1998

Cited by 1,525 publications

References 99 publications

Second cancer risk after radiation therapy of ependymoma using the flattening filter free irradiation mode of a linear accelerator

Second cancer risk after radiation therapy of ependymoma using the flattening filter free irradiation mode of a linear accelerator

Pediatric Thyroid Cancers: An Indian Perspective

Secondary malignancies among nonseminomatous germ cell tumor cancer survivors

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