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1.
Medicine (Baltimore) ; 100(16): e25373, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879666

RESUMO

INTRODUCTION: Radiation induced gliomas often occurs after radiation therapy for other brain tumors. Medulloblastoma often occurs in children and its associated radiation-induced glioblastoma multiforme's (GBM) after radiotherapy often has a long latency period. Our case is very unique because the medulloblastoma was detected at an advance age and the latency period of radiation-induced GBM was relatively shorter. PATIENTS CONCERNS: A 64-year-old male was first admitted at our hospital in March 2018 with dizziness, vomiting, and blurred vision. DIAGNOSIS: Magnetic resonance imaging of brain revealed a lesion with local mixed density and mass enhancement in left cerebellar region. Histopathology established medulloblastoma (World Health Organization) grade 4 and a classic histological subtype after surgery. INTERVENTION: Surgical resection followed by radiation therapy were the initial therapeutic modalities. OUTCOMES: In April 2019, the patient was readmitted with dizziness and blurred vision. Magnetic resonance imaging showed the left cerebellar hemisphere bulky enhancement lesion. Again, a multimodal therapy comprising surgical resection, radiation therapy as well as chemotherapy was adapted after histopathology established GBM. LESION: Radiotherapy for medulloblastoma patients at advance ages is a critical predisposing factor for the development of radiation-induced GBM in a very short period of time. We suggest that, radiotherapy as adjuvant therapy for medulloblastoma patients at advance ages should be chosen with extreme caution.


Assuntos
Neoplasias Cerebelares/terapia , Glioblastoma/etiologia , Meduloblastoma/terapia , Neoplasias Induzidas por Radiação/etiologia , Radioterapia Adjuvante/efeitos adversos , Terapia Combinada , Humanos , Masculino , Pessoa de Meia-Idade
2.
Bull Cancer ; 108(4): 352-358, 2021 Apr.
Artigo em Francês | MEDLINE | ID: mdl-33678407

RESUMO

In a few situations, the consequences secondary to a carcinological pathology require an assessment of damages for compensatory purposes. This is particularly the case when liable parties have been found to be at cause of the disease: occupational pathologies in the case of inexcusable employer's fault, exposure to a radioactive risk, for example in the context of full compensation for damages suffered by the victims of nuclear experiments performed by France, or lastly, in the after-effects of late diagnosis. This article does not discuss the imputability of cancer pathologies to an event, but it proposes an adaptation of methods for assessing damages, in an attempt to provide full compensation for damages.


Assuntos
Compensação e Reparação/legislação & jurisprudência , Responsabilidade Legal , Neoplasias , Doenças Profissionais , Causalidade , Avaliação da Deficiência , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Estética , França , Experimentação Humana/legislação & jurisprudência , Humanos , Deficiências da Aprendizagem/etiologia , Responsabilidade Legal/economia , Neoplasias/economia , Neoplasias/etiologia , Neoplasias/psicologia , Neoplasias/terapia , Neoplasias Induzidas por Radiação/economia , Neoplasias Induzidas por Radiação/etiologia , Doenças Profissionais/economia , Doenças Profissionais/etiologia , Dor , Complicações Pós-Operatórias , Lesões por Radiação/economia , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Disfunções Sexuais Fisiológicas/etiologia , Responsabilidade Social
3.
Radiat Res ; 195(4): 397-400, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33577680

RESUMO

In most studies on radiation workers, the incidence of thyroid cancer was determined to be higher than among the general population; this is generally assumed to be due to overdiagnosis through thyroid screening. However, there is a lack of evidence on the association between thyroid screening and increased thyroid cancer incidence in most occupational studies. In this study, we compared thyroid cancer screening rates between the general population and radiation workers with various occupations and examined the relationship between these rates and thyroid cancer incidence. We compared thyroid screening rates between radiation workers and the general population with age- and sex-standardized screening ratios (SSRs) using data from two national surveys conducted during 2015-2017 in Korea, and assessed the correlation between these ratios and age- and sex-standardized incidence ratios (SIRs) for thyroid cancer. Screening rates were higher among radiation workers than among the general population, with an overall SSR of 1.58 (95% confidence interval: 1.54-1.62). When various types of occupations were compared, those with an increased SSR also had an increased SIR. SSRs remained high even when the screening period was restricted to the year preceding the survey (the year after the establishment of guidelines for thyroid cancer screening aimed at reducing overdiagnosis). In conclusion, the increased incidence of thyroid cancer among radiation workers compared to that among the general population can be attributed mainly to increased thyroid screening rates. Additional efforts are needed to reduce unnecessary thyroid cancer screening in occupational populations, particularly in those with better access to healthcare, in terms of clinical rationale and for assessing the true increase in thyroid cancer incidence.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Detecção Precoce de Câncer/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/patologia , Doenças Profissionais/patologia , Doses de Radiação , Medição de Risco , Fatores de Risco , Neoplasias da Glândula Tireoide/etiologia , Neoplasias da Glândula Tireoide/patologia
4.
Cancer Radiother ; 25(2): 114-118, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33487559

RESUMO

PURPOSE: The breast sarcoma induced by radiation therapy is rare but increasing, given the increased long-term survival of patients receiving radiation therapy. Fibrosarcoma, histiocytofibroma and angiosarcoma are the most common breast sarcoma. Angiosarcoma is the most common after breast cancer treated by radiation therapy, often diagnosed too late, with a severe prognosis and a high rate of recurrence. However, because of the low incidence of angiosarcoma associated with radiation therapy (AAR), the benefit of radiation therapy in breast cancer treatment outweighs the risk to develop angiosarcoma. The aim of this study is to evaluate these rare cases of AAR diagnosed in eastern Belgium in comparison to the data from the literature. PATIENTS AND METHODS: Nine cases of AAR after radiation for breast ductal carcinoma were included in this retrospective study. AAR was diagnosed according to Cahan criteria between January 2007 and December 2016. Latency, incidence, management and prognosis are comparable to the literature. RESULTS, CONCLUSION: The median latency was 10 (4-24) years, the incidence of AAR in the East Belgian area was 0.09% of the patients irradiated on the same period. Patients were treated by surgery with wide local excision with or without reconstructive surgery, without radiotherapy and chemotherapy treatment. Kaplan-Meier analysis showed median overall survival of 61.8 months, patient survival of 55.6% at one year and 29.6% at five years. With the constant progress of medicine and its technologies, it would be possible to limit the occurrence of AAR or to diagnose it at an earlier stage.


Assuntos
Neoplasias da Mama/etiologia , Neoplasias da Mama/radioterapia , Carcinoma Ductal de Mama/radioterapia , Hemangiossarcoma/etiologia , Neoplasias Induzidas por Radiação/etiologia , Segunda Neoplasia Primária/etiologia , Idoso , Idoso de 80 Anos ou mais , Bélgica/epidemiologia , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Ductal de Mama/mortalidade , Feminino , Hemangiossarcoma/epidemiologia , Hemangiossarcoma/mortalidade , Hemangiossarcoma/cirurgia , Humanos , Incidência , Estimativa de Kaplan-Meier , Mastectomia , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/mortalidade , Neoplasias Induzidas por Radiação/cirurgia , Segunda Neoplasia Primária/epidemiologia , Segunda Neoplasia Primária/mortalidade , Segunda Neoplasia Primária/cirurgia , Doenças Raras/epidemiologia , Doenças Raras/etiologia , Doenças Raras/mortalidade , Doenças Raras/cirurgia , Estudos Retrospectivos , Análise de Sobrevida , Fatores de Tempo , Neoplasias Unilaterais da Mama/epidemiologia , Neoplasias Unilaterais da Mama/etiologia , Neoplasias Unilaterais da Mama/mortalidade
5.
Mol Carcinog ; 60(3): 172-178, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33482042

RESUMO

Although beta 2 adrenergic receptors (ß2 ADR) are present in the keratinocytes, their role in cutaneous squamous cell tumorigenesis needs to be ascertained. For the first time, we report here that selective ß2 ADR antagonists by inhibiting ß2 ADR actions significantly retarded the progression of ultraviolet B (UVB) induced premalignant cutaneous squamous cell lesions. These antagonists acted by inhibiting vascular endothelial growth factor-A (VEGF) mediated angiogenesis to prevent UVB radiation-induced squamous cell carcinoma of the skin.


Assuntos
Antagonistas de Receptores Adrenérgicos beta 2/farmacologia , Neoplasias de Células Escamosas/tratamento farmacológico , Neoplasias Cutâneas/tratamento farmacológico , Raios Ultravioleta/efeitos adversos , Agonistas de Receptores Adrenérgicos beta 1/farmacologia , Animais , Butoxamina/farmacologia , Humanos , Queratinócitos/metabolismo , Queratinócitos/efeitos da radiação , Masculino , Camundongos Endogâmicos , Neoplasias Induzidas por Radiação/irrigação sanguínea , Neoplasias Induzidas por Radiação/tratamento farmacológico , Neoplasias Induzidas por Radiação/etiologia , Neoplasias de Células Escamosas/irrigação sanguínea , Neoplasias de Células Escamosas/etiologia , Neovascularização Patológica/tratamento farmacológico , Neovascularização Patológica/metabolismo , Receptores Adrenérgicos beta 2/metabolismo , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Cutâneas/etiologia , Fator A de Crescimento do Endotélio Vascular/metabolismo , Xamoterol/farmacologia
6.
BMJ Case Rep ; 14(1)2021 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-33462035

RESUMO

Esthesioneuroblastoma (ENB) is an uncommon sinonasal cancer of the olfactory neuroepithelium that is typically treated with surgical resection followed by radiation therapy. Radiation-induced intracranial osteosarcoma of the skull base is a rare but devastating long-term complication of radiation therapy in this region. Here, we present a case of an 82-year-old patient who developed radiation-induced osteosarcoma of the anterior skull base and paranasal sinuses 10 years after radiation therapy following resection of an ENB. Older patients may be at risk of developing this complication earlier and with a worse prognosis relative to younger patients. Treating physicians/surgeons should be aware of this devastating complication. Patients who are treated with high-dose radiation therapy in this region should be followed for many years.


Assuntos
Estesioneuroblastoma Olfatório/radioterapia , Cavidade Nasal , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Nasais/radioterapia , Osteossarcoma/etiologia , Neoplasias da Base do Crânio/etiologia , Idoso de 80 Anos ou mais , Feminino , Humanos , Neoplasias Induzidas por Radiação/diagnóstico , Osteossarcoma/diagnóstico , Neoplasias da Base do Crânio/diagnóstico
7.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334766

RESUMO

Radiation-induced spinal glioblastoma is an extremely rare disease with only four previously published reports in the literature. We report the fifth case, a 69-year-old woman who previously underwent treatment with brachytherapy for cervical cancer, and thereafter presented with neurologic deficits from a conus medullaris tumour. Biopsy and histopathology confirm glioblastoma, not otherwise specified. Treatment of spinal glioblastoma consists of surgery, either biopsy or excision and chemoradiation. However, results are still unsatisfactory and prognosis remains poor.


Assuntos
Braquiterapia/efeitos adversos , Glioblastoma/diagnóstico , Neoplasias Induzidas por Radiação/diagnóstico , Neoplasias da Medula Espinal/diagnóstico , Neoplasias do Colo do Útero/radioterapia , Idoso , Biópsia , Procedimentos Cirúrgicos de Citorredução , Feminino , Glioblastoma/etiologia , Glioblastoma/patologia , Glioblastoma/cirurgia , Humanos , Laminectomia , Imagem por Ressonância Magnética , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/patologia , Neoplasias Induzidas por Radiação/cirurgia , Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Medula Espinal/efeitos da radiação , Medula Espinal/cirurgia , Neoplasias da Medula Espinal/etiologia , Neoplasias da Medula Espinal/patologia , Neoplasias da Medula Espinal/cirurgia
8.
Medicine (Baltimore) ; 99(45): e23105, 2020 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-33157985

RESUMO

The relationship between solar ultraviolet radiation and the risk of breast cancer is conflicting. The purpose of our study was to quantitatively assess the relationship between solar ultraviolet radiation and breast cancer risk and to analyze related factors such as age and sunscreen use.Articles indexed in PubMed and Embase and published between January 2005 and March 2020 were searched for relevant keywords. The relative risk was calculated using random-effect or fixed-effect models in the meta-analysis and dose-response meta-analysis, which were conducted according to the Meta-Analyses of Observational Studies in Epidemiology reporting guidelines. Sensitivity analyses for heterogeneity and publication bias were evaluated.Six studies were eligible for inclusion in the meta-analysis, and three of these were included in the dose-response analysis. We found a correlation between exposure to solar ultraviolet radiation and breast cancer risk (relative risk: 0.70, 95% confidence interval: 0.65, 0.75). We also found a linear dose-response relationship between the exposure and breast cancer risk (relative risk: 0.86, 95% confidence interval: 0.81, 0.91) in women over 40. Not tanning and covering the limbs were associated with breast cancer risk, but sunscreen use was not.Exposure to solar ultraviolet radiation is negatively correlated with breast cancer risk, and the association is linear in women over 40. This is the first dose-response meta-analysis on the topic, and the influence of factors such as estrogen receptor status, occupational exposure, and ethnicity requires in-depth study.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Exposição à Radiação/efeitos adversos , Luz Solar/efeitos adversos , Raios Ultravioleta/efeitos adversos , Relação Dose-Resposta à Radiação , Feminino , Humanos , Medição de Risco
9.
Adv Exp Med Biol ; 1268: 19-36, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918212

RESUMO

Vitamin D is the sunshine vitamin for good reason. During exposure to sunlight, the ultraviolet B photons enter the skin and photolyze 7-dehydrocholesterol to previtamin D3 which in turn is isomerized by the body's temperature to vitamin D3. Most humans have depended on sun for their vitamin D requirement. Skin pigment, sunscreen use, aging, time of day, season, and latitude dramatically affect previtamin D3 synthesis. Vitamin D deficiency was thought to have been conquered, but it is now recognized that more than 50% of the world's population is at risk for vitamin D deficiency. This deficiency is in part due to the inadequate fortification of foods with vitamin D and the misconception that a healthy diet contains an adequate amount of vitamin D. Vitamin D deficiency causes growth retardation and rickets in children and will precipitate and exacerbate osteopenia, osteoporosis and increase risk of fracture in adults. The vitamin D deficiency pandemic has other serious consequences including increased risk of common cancers, autoimmune diseases, infectious diseases, and cardiovascular disease. There needs to be a renewed appreciation of the beneficial effect of moderate sensible sunlight for providing all humans with their vitamin D requirement for health.


Assuntos
Saúde , Neoplasias Cutâneas , Luz Solar , Raios Ultravioleta , Vitamina D , Humanos , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/prevenção & controle , Medição de Risco , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Deficiência de Vitamina D/epidemiologia
10.
Adv Exp Med Biol ; 1268: 143-154, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32918217

RESUMO

Solar UV exposure is critical and complex in the etiology and prognosis of skin cancer, particularly cutaneous malignant melanoma. Sun exposure and one of its "derivatives," vitamin D, have been implicated in protection against mortality from melanoma. However, the relationships are inconsistent. At this time, it is not possible to make clear recommendations for or against sun exposure in relationship to melanoma prognosis. However, this relationship deserves continued exploration.


Assuntos
Neoplasias Cutâneas/mortalidade , Raios Ultravioleta , Humanos , Melanoma/etiologia , Melanoma/mortalidade , Melanoma/prevenção & controle , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/mortalidade , Neoplasias Induzidas por Radiação/prevenção & controle , Prognóstico , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/prevenção & controle , Raios Ultravioleta/efeitos adversos , Vitamina D
11.
Clin Imaging ; 67: 226-236, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871427

RESUMO

PURPOSE: Digital radiography has the potential to improve the practice of radiography but it also has the potential to significantly increase patient doses. Considering rapidly growing digital radiography in many centers, concerns rise about increasing the collective dose of the human population and following health effects. This study aimed to estimate organ and effective doses and calculate the lifetime attributable risk (LAR) of cancer incidence and mortality in digital radiography procedures in Iran. METHODS: Organ and effective doses of 12 routine digital radiography examinations including the skull, cervical spine, chest, thoracic spine, lumbar spine, pelvic and abdomen were estimated using PCXMC software based on Monte Carlo simulation method. Then, LARs of cancer incidence and mortality were estimated using the BEIR VII method. RESULTS: Organ doses ranged from 0.01 to a maximum of 2.5 mGy while effective doses ranged from 0.01 to 0.7 mSv. Radiation risk showed dependence on the X-ray examination type and the patient's sex and age. In skull and cervical X-rays, the thyroid; in the chest and thoracic spine X-rays, the lung, and breast; and in the lumbar spine, pelvic and abdominal X-rays, the colon and bladder had the highest LAR of cancer incidence and mortality. Furthermore, younger patients and also females were at higher radiation risk. CONCLUSION: The lifetime attributable risk of cancer incidence and mortality due to radiation exposure is not trivial. Therefore efforts should be made to reduce patient doses while maintaining image quality.


Assuntos
Neoplasias Induzidas por Radiação/epidemiologia , Abdome , Mama , Feminino , Humanos , Incidência , Masculino , Método de Monte Carlo , Pescoço , Neoplasias Induzidas por Radiação/etiologia , Pelve , Doses de Radiação , Intensificação de Imagem Radiográfica , Radiografia , Fatores de Risco , Software , Coluna Vertebral , Tórax
12.
Artigo em Russo | MEDLINE | ID: mdl-32649814

RESUMO

BACKGROUND: Development of meningiomas correlating with irradiation has been described in the last century. Different biological features of radiation-induced meningiomas depending on dose and type of irradiation have been observed in recent years. MATERIAL AND METHODS: There were 8848 patients (women - 74.3%) with intracranial meningiomas for the period from 2000 to 2014 who underwent surgery at the Burdenko Neurosurgical Center. Radiation-induced meningiomas were identified in 33 patients (13 (38%) men and 20 (62%) women) aged 16-76 years (median 56 years). Medical data were retrospectively analyzed. Follow-up period ranged from 5 to 22 years (median 12) after verification of histological diagnosis. Meningiomas were preceded by X-ray irradiation of the scalp for ringworm (microsporia or trichophytosis) in 26 cases (79%) (group A). Group B enrolled 7 (21%) patients after previous radiotherapy for other tumors (retinoblastoma, chiasmal glioma, pituitary adenoma, basalioma). Data were compared using Mann-Whitney and Fisher's exact tests. RESULTS AND DISCUSSION: Incidence of radiation-induced meningiomas was 0.37% in our sample. Meningioma diagnosis dates after X-ray epilation (median 52 years) significantly differed from that after radiotherapy (median 22 years) (Mann-Whitney test, p=0.0003). Primary multiple meningiomas were diagnosed only in the 1st group (Fisher's exact test, p=0.0005). Recurrent meningiomas after the first surgery were more common in the first group (58%) compared to the second one (14%) (Mann-Whitney test, p=0.0003). CONCLUSIONS: The latency period is shorter after radiotherapy (median 22 years compared to 52 years after X-ray epilation). Incidence of atypical and malignant meningiomas directly correlates with irradiation dose. Approximately equal incidence of radiation-induced meningiomas after X-ray epilation in women and men can indicate other mechanisms of development of these tumors in comparison with spontaneous ones. Radiotherapy is followed by occurrence of meningiomas within the irradiated area. These tumors are usually single. In case of X-ray epilation, the tumors may be localized anywhere within the intracranial space (convexital and/or parasagittal localization in 77% of cases). Multiple neoplasms occur in 42% of cases. Refusal of head X-ray epilation for the treatment of a ringworm for the last 50 years may be followed by reduced incidence of radiation-induced meningiomas, especially multiple ones. However, extended indications for radiotherapy of various brain diseases can result an increase of the incidence of meningiomas within the irradiated area.


Assuntos
Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Estudos Retrospectivos , Adulto Jovem
13.
Dermatol Online J ; 26(3)2020 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-32609442

RESUMO

Gel nails are a common artificial nail option. Ultraviolet (UV) nail lamps are commonly used to cure gel nails. Ultraviolet A radiation is a known mutagen that penetrates into the nail bed. Although previously reported, the role of UV nail lamps in the carcinogenesis of both keratinocyte carcinoma and melanoma remains controversial. Herein, we report a patient taking the photosensitizing agent hydrochlorothiazide who developed numerous squamous cell carcinomas on the dorsal hands and feet with a 10-year history of UV nail light exposure every 2-3 weeks.


Assuntos
Carcinoma de Células Escamosas/etiologia , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Cutâneas/etiologia , Raios Ultravioleta/efeitos adversos , Idoso , Indústria da Beleza , Feminino , Pé/efeitos da radiação , Mãos/efeitos da radiação , Humanos , Hidroclorotiazida/efeitos adversos , Hidroclorotiazida/uso terapêutico , Doença de Meniere/tratamento farmacológico , Unhas , Fármacos Fotossensibilizantes/efeitos adversos , Fármacos Fotossensibilizantes/uso terapêutico , Fatores de Risco
16.
PLoS One ; 15(4): e0232597, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32353063

RESUMO

The use of low doses of radium-224 (224Ra) chloride for the treatment of ankylosing spondylitis was stopped following the discovery that patients treated with it had a higher than control incidence of leukaemia and other cancers. This was so even though the treatment resulted in decreased pain and increased mobility-both of which are associated with decreased mortality. It was decided to re-analyze the epidemiological data looking at all causes of death. The risk of leukaemia, solid cancer, death from non-cancer causes and from all causes in a study populations of men that received either the typical dose of 5.6 to 11.1 MBq of 224Ra, any dose of 224Ra or no radium were compared using the Cox proportional hazard model. For patients that received the typical dose of 224Ra agreed with the excess cancer was similar to that reported in previous studies. In contrast, these patients were less likely to die from non-cancer diseases and from all causes of death than the control patients. No excess mortality was also found in the population of all males that received the radionuclide. It is concluded that 224Ra treatment administered at low doses to patients with ankylosing spondylitis did not impact mortality from all causes. The study demonstrates the need to consider all causes of death and longevity when assessing health impacts following irradiation.


Assuntos
Causas de Morte , Leucemia/mortalidade , Neoplasias Induzidas por Radiação/mortalidade , Rádio (Elemento)/administração & dosagem , Retirada de Medicamento Baseada em Segurança , Espondilite Anquilosante/radioterapia , Tório/administração & dosagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Relação Dose-Resposta à Radiação , Seguimentos , Humanos , Injeções Intravenosas , Leucemia/etiologia , Masculino , Pessoa de Meia-Idade , Neoplasias Induzidas por Radiação/etiologia , Dosagem Radioterapêutica , Rádio (Elemento)/efeitos adversos , Espondilite Anquilosante/mortalidade , Tório/efeitos adversos , Fatores de Tempo
17.
Cancer Treat Rev ; 87: 102027, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32428791

RESUMO

Immune checkpoint inhibitors (ICI) have improved outcomes for patients with advanced cancers, and results in increasing numbers of long-term survivors. For registration studies, progression-free survival and disease-free survival often serve as primary endpoints. This requires repeated computed tomography (CT) scans for tumour imaging which might lead to major radiation exposure. To determine this, all immune checkpoint inhibitors trials that led to FDA approval were retrieved up to July 29, 2019. From the available protocols, imaging modalities and schedules used in each trial were identified. The anticipated cumulative number of scans made after 1, 3, 5, and 10 years study participation were calculated. The percentage of lifetime attributable cancer risk was calculated using the Biological Effects of Ionizing Radiation VII report. Fifty-one trials were identified, from which 39 protocols were retrieved. Four were adjuvant trials. All protocols required repeated chest-abdomen imaging and specified CT scans as preferred imaging modality. Median calculated cumulative numbers of chest-abdomen CT scans after 1, 3, 5, and 10 years study participation were 7, 16, 24 and 46, respectively. For ages 20-70 years at study entry, the average lifetime attributable cancer risk after 1 year of study participation ranged from 1.11 to 0.40% for men and from 1.87 to 0.46% for women. At 10 years study participation, this risk increased to a range of 5.91 to 1.96% for men and 9.64 to 2.32% for women. Given high imaging radiation exposure for long-term survivors in current ICI trials an adaptive imaging interval and imaging termination rules should be considered for long-term survivors.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias/diagnóstico por imagem , Adulto , Feminino , Humanos , Imagem por Ressonância Magnética/estatística & dados numéricos , Masculino , Neoplasias/tratamento farmacológico , Neoplasias/epidemiologia , Neoplasias/imunologia , Neoplasias Induzidas por Radiação/etiologia , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adulto Jovem
19.
Br J Radiol ; 93(1110): 20190869, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32242740

RESUMO

OBJECTIVES: To estimate risk for exposure-induced cancer death (REID), organ-specific risks of exposure-induced cancer death (REIDHT) and associated conversion coefficients (CCREID:KAP=REID/kerma-area product (KAP), CCREIDHT:KAP=REIDHT/KAP) in paediatric cardiac catheterizations using data from radiation dose structured reports (RDSR). A novel risk surveillance tool consisting of age-specific and gender-specific risk reference values (RRVs) related to population cancer risk is suggested. METHODS: The PCXMC v.2.0 code is used together with exposure-related information from RDSR from a cohort of 238 children to assess cancer risks and related conversion coefficients. The KAP corresponding to 1 in 1000 of increased REID is used to define age-specific and gender-specific KAP values to monitor risk in such patient cohorts, here denoted as RRVs. RESULTS: The REID estimates ranged from below 1 up to 300 in 100,000, and the RRVs for the different age groups and gender ranged from 0.77 Gycm2 and 2.1 Gycm2 for neonates (female, male) to 11 Gycm2 and 25 Gycm2 for 15-year-olds (female, male). The CCREID:KAP and CCREIDHT:KAP decreased biexponentially with increased age, being notably higher for female patients. CONCLUSIONS: Prominent risk contributing organs were the lungs and the (female) breast. The concept of age-specific and gender-specific RRVs related to population cancer risk is introduced and is intended to be used as a supporting tool for physicians performing such interventions. ADVANCES IN KNOWLEDGE: Age-related and gender-related conversion coefficients for radiation risk, CCREID:KAP and CCREIDHT:KAP, are introduced and a novel risk surveillance concept, the RRV, is suggested for paediatric cardiac catheterizations.


Assuntos
Fatores Etários , Cateterismo Cardíaco/efeitos adversos , Cardiopatias Congênitas/diagnóstico por imagem , Neoplasias Induzidas por Radiação/mortalidade , Exposição à Radiação/efeitos adversos , Fatores Sexuais , Adolescente , Angiografia , Neoplasias da Mama/etiologia , Neoplasias da Mama/mortalidade , Cateterismo Cardíaco/métodos , Criança , Pré-Escolar , Feminino , Cardiopatias Congênitas/radioterapia , Cardiopatias Congênitas/cirurgia , Humanos , Lactente , Recém-Nascido , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/mortalidade , Masculino , Neoplasias Induzidas por Radiação/etiologia , Especificidade de Órgãos/efeitos da radiação , Imagens de Fantasmas , Doses de Radiação , Valores de Referência , Risco
20.
Pediatr Blood Cancer ; 67(6): e28189, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32286018

RESUMO

BACKGROUND: Despite improved survival, many pediatric brain tumor survivors receiving radiation therapy (RT) experience late effects. PROCEDURE: To study calvarial lesions in this population, we retrospectively reviewed records of patients undergoing neurosurgical evaluation for calvarial bone lesions detected in posttreatment follow-up imaging at St. Jude Children's Research Hospital. Primary tumor diagnosis, treatment, imaging, surgical intervention, and histopathology from patients with radiographic evidence of lesions followed for ≥2 years post-RT were studied. RESULTS: For 17 patients with 18 index lesions, median time to lesion manifestation was 2.34 years. Medulloblastoma patients developed lesions at a shorter interval from RT than ependymoma patients (P = .05). Twelve of 14 lesions requiring surgery were benign fibro-osseous or sclerotic. Two malignant lesions distinct from the primary tumor had genetic predisposition to malignancy. CONCLUSION: Most calvarial lesions arising post-RT are benign and fibro-osseous. Serial imaging is recommended, and high index of suspicion for malignant lesions is warranted for patients genetically predisposed to cancer.


Assuntos
Sobreviventes de Câncer/estatística & dados numéricos , Neoplasias Cerebelares/radioterapia , Ependimoma/radioterapia , Meduloblastoma/radioterapia , Neoplasias Induzidas por Radiação/patologia , Radioterapia/efeitos adversos , Neoplasias Cranianas/patologia , Adolescente , Neoplasias Cerebelares/patologia , Criança , Pré-Escolar , Ependimoma/patologia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Meduloblastoma/patologia , Neoplasias Induzidas por Radiação/etiologia , Neoplasias Induzidas por Radiação/terapia , Prognóstico , Estudos Retrospectivos , Neoplasias Cranianas/etiologia , Neoplasias Cranianas/terapia
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