SECOND MALIGNANT NEOPLASMS AND CARDIOVASCULAR DISEASE FOLLOWING RADIOTHERAPY

被引:30
|
作者
Travis, Lois B. [1 ,2 ]
Ng, Andrea K. [3 ,4 ]
Allan, James M. [5 ]
Pui, Ching-Hon [6 ,7 ]
Kennedy, Ann R. [8 ]
Xu, X. George [9 ]
Purdy, James A. [10 ]
Applegate, Kimberly [11 ]
Yahalom, Joachim [12 ]
Constine, Louis S. [1 ,2 ]
Gilbert, Ethel S. [13 ]
Boice, John D., Jr. [14 ,15 ]
机构
[1] Univ Rochester, Med Ctr, Rubin Ctr Canc Survivorship, Rochester, NY 14642 USA
[2] Univ Rochester, Med Ctr, James P Wilmot Canc Ctr, Dept Radiat Oncol, Rochester, NY 14642 USA
[3] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Radiat Oncol, Boston, MA 02115 USA
[4] Dana Farber Canc Inst, Boston, MA 02115 USA
[5] Newcastle Univ, Northern Inst Canc Res, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England
[6] St Jude Childrens Res Hosp, Dept Oncol, Memphis, TN 38105 USA
[7] Univ Tennessee, Ctr Hlth Sci, Memphis, TN 38163 USA
[8] Univ Penn, Sch Med, Dept Radiat Oncol, Philadelphia, PA 19104 USA
[9] Rensselaer Polytech Inst, Nucl Engn & Engn Phys Program, Troy, NY USA
[10] Univ Calif Davis, Dept Radiat Oncol, Davis, CA 95616 USA
[11] Emory Univ, Dept Radiol, Atlanta, GA 30322 USA
[12] Mem Sloan Kettering Canc Ctr, Dept Radiat Oncol, New York, NY 10021 USA
[13] NCI, Div Canc Epidemiol & Genet, Bethesda, MD 20892 USA
[14] Natl Council Radiat Protect & Measurements, Bethesda, MD USA
[15] Vanderbilt Univ, Dept Med, Nashville, TN USA
来源
HEALTH PHYSICS | 2014年 / 106卷 / 02期
基金
美国国家卫生研究院;
关键词
cancer; health effects; medical radiation; National Council on Radiation Protection and Measurements; RADIATION-THERAPY; TESTICULAR CANCER; BREAST-CANCER; HODGKINS-DISEASE; RISK; CHEMOTHERAPY; CARCINOMA; SURVIVORS; ROLES; SUSCEPTIBILITY;
D O I
10.1097/HP.0000000000000013
中图分类号
X [环境科学、安全科学];
学科分类号
08 ; 0830 ;
摘要
Second malignant neoplasms (SMNs) and cardiovascular disease (CVD) are among the most serious and life-threatening late adverse effects experienced by the growing number of cancer survivors worldwide and are due in part to radiotherapy. The National Council on Radiation Protection and Measurements (NCRP) convened an expert scientific committee to critically and comprehensively review associations between radiotherapy and SMNs and CVD, taking into account radiobiology; genomics; treatment (i.e., radiotherapy with or without chemotherapy and other therapies); type of radiation; and quantitative considerations (i.e., dose-response relationships). Major conclusions of the NCRP include: (1) the relevance of older technologies for current risk assessment when organ-specific absorbed dose and the appropriate relative biological effectiveness are taken into account and (2) the identification of critical research needs with regard to newer radiation modalities, dose-response relationships, and genetic susceptibility. Recommendation for research priorities and infrastructural requirements include (1) long-term large-scale follow-up of extant cancer survivors and prospectively treated patients to characterize risks of SMNs and CVD in terms of radiation dose and type; (2) biological sample collection to integrate epidemiological studies with molecular and genetic evaluations; (3) investigation of interactions between radiotherapy and other potential confounding factors, such as age, sex, race, tobacco and alcohol use, dietary intake, energy balance, and other cofactors, as well as genetic susceptibility; (4) focusing on adolescent and young adult cancer survivors, given the sparse research in this population; and (5) construction of comprehensive risk prediction models for SMNs and CVD to permit the development of follow-up guidelines and prevention and intervention strategies.
引用
收藏
页码:229 / 246
页数:18
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