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Yamada Y, Imaoka T, Iwasaki T, Kobayashi J, Misumi M, Sakai K, Sugihara T, Suzuki K, Tauchi H, Yasuda H, Yoshinaga S, Sasatani M, Tanaka S, Doi K, Tomita M, Iizuka D, Kakinuma S, Sasaki M, Kai M. Establishment and activity of the planning and acting network for low dose radiation research in Japan (PLANET): 2016-2023. JOURNAL OF RADIATION RESEARCH 2024; 65:561-574. [PMID: 39007844 PMCID: PMC11420843 DOI: 10.1093/jrr/rrae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/28/2024] [Indexed: 07/16/2024]
Abstract
The Planning and Acting Network for Low Dose Radiation Research in Japan (PLANET) was established in 2017 in response to the need for an all-Japan network of experts. It serves as an academic platform to propose strategies and facilitate collaboration to improve quantitative estimation of health risks from ionizing radiation at low-doses and low-dose-rates. PLANET established Working Group 1 (Dose-Rate Effects in Animal Experiments) to consolidate findings from animal experiments on dose-rate effects in carcinogenesis. Considering international trends in this field as well as the situation in Japan, PLANET updated its priority research areas for Japanese low-dose radiation research in 2023 to include (i) characterization of low-dose and low-dose-rate radiation risk, (ii) factors to be considered for individualization of radiation risk, (iii) biological mechanisms of low-dose and low-dose-rate radiation effects and (iv) integration of epidemiology and biology. In this context, PLANET established Working Group 2 (Dose and Dose-Rate Mapping for Radiation Risk Studies) to identify the range of doses and dose rates at which observable effects on different endpoints have been reported; Working Group 3 (Species- and Organ-Specific Dose-Rate Effects) to consider the relevance of stem cell dynamics in radiation carcinogenesis of different species and organs; and Working Group 4 (Research Mapping for Radiation-Related Carcinogenesis) to sort out relevant studies, including those on non-mutagenic effects, and to identify priority research areas. These PLANET activities will be used to improve the risk assessment and to contribute to the revision of the next main recommendations of the International Commission on Radiological Protection.
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Affiliation(s)
- Yutaka Yamada
- Department of Radiation Effects Research, Institute for Radiological Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Tatsuhiko Imaoka
- Department of Radiation Effects Research, Institute for Radiological Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Toshiyasu Iwasaki
- Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry, 1646 Abiko, Abiko, Chiba 270-1194, Japan
| | - Junya Kobayashi
- Department of Radiological Sciences, School of Health Sciences at Narita, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan
| | - Munechika Misumi
- Department of Statistics, Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Kazuo Sakai
- Tokyo Healthcare University, 2-5-1 Higashiaoka, Meguro-ku, Tokyo 152-8558, Japan
| | - Takashi Sugihara
- Department of Radiobiology, Institute for Environmental Sciences, 1-7 Ienomae, Obuchi, Rokkasho-mura, Kamikita-gun, Aomori 039-3212, Japan
| | - Keiji Suzuki
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan
| | - Hiroshi Tauchi
- Department of Biological Sciences, Ibaraki University, Bunkyo 2-1-1, Mito, Ibaraki 310-8512, Japan
| | - Hiroshi Yasuda
- Department of Radiation Biophysics, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Shinji Yoshinaga
- Department of Environmetrics and Biometrics, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Megumi Sasatani
- Department of Experimental Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8553, Japan
| | - Satoshi Tanaka
- Department of Radiobiology, Institute for Environmental Sciences, 1-7 Ienomae, Obuchi, Rokkasho-mura, Kamikita-gun, Aomori 039-3212, Japan
| | - Kazutaka Doi
- Department of Radiation Regulatory Science Research, Institute for Radiological Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Masanori Tomita
- Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry, 1646 Abiko, Abiko, Chiba 270-1194, Japan
| | - Daisuke Iizuka
- Department of Radiation Effects Research, Institute for Radiological Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Shizuko Kakinuma
- Department of Radiation Effects Research, Institute for Radiological Science, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba 263-8555, Japan
| | - Michiya Sasaki
- Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry, 1646 Abiko, Abiko, Chiba 270-1194, Japan
| | - Michiaki Kai
- Nippon Bunri University, 1727-162 Ichiki, Oita, Oita 870-0397, Japan
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Little MP, Bazyka D, de Gonzalez AB, Brenner AV, Chumak VV, Cullings HM, Daniels RD, French B, Grant E, Hamada N, Hauptmann M, Kendall GM, Laurier D, Lee C, Lee WJ, Linet MS, Mabuchi K, Morton LM, Muirhead CR, Preston DL, Rajaraman P, Richardson DB, Sakata R, Samet JM, Simon SL, Sugiyama H, Wakeford R, Zablotska LB. A Historical Survey of Key Epidemiological Studies of Ionizing Radiation Exposure. Radiat Res 2024; 202:432-487. [PMID: 39021204 PMCID: PMC11316622 DOI: 10.1667/rade-24-00021.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 04/23/2024] [Indexed: 07/20/2024]
Abstract
In this article we review the history of key epidemiological studies of populations exposed to ionizing radiation. We highlight historical and recent findings regarding radiation-associated risks for incidence and mortality of cancer and non-cancer outcomes with emphasis on study design and methods of exposure assessment and dose estimation along with brief consideration of sources of bias for a few of the more important studies. We examine the findings from the epidemiological studies of the Japanese atomic bomb survivors, persons exposed to radiation for diagnostic or therapeutic purposes, those exposed to environmental sources including Chornobyl and other reactor accidents, and occupationally exposed cohorts. We also summarize results of pooled studies. These summaries are necessarily brief, but we provide references to more detailed information. We discuss possible future directions of study, to include assessment of susceptible populations, and possible new populations, data sources, study designs and methods of analysis.
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Affiliation(s)
- Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
- Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Oxford, OX3 0BP, UK
| | - Dimitry Bazyka
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | | | - Alina V. Brenner
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Vadim V. Chumak
- National Research Center for Radiation Medicine, Hematology and Oncology, 53 Melnikov Street, Kyiv 04050, Ukraine
| | - Harry M. Cullings
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Eric Grant
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 1646 Abiko, Chiba 270-1194, Japan
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany
| | - Gerald M. Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay aux Roses France
| | - Choonsik Lee
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Won Jin Lee
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Martha S. Linet
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Lindsay M. Morton
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | | | | | - Preetha Rajaraman
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - David B. Richardson
- Environmental and Occupational Health, 653 East Peltason, University California, Irvine, Irvine, CA 92697-3957 USA
| | - Ritsu Sakata
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Jonathan M. Samet
- Department of Epidemiology, Colorado School of Public Health, Aurora, Colorado, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, MD 20892-9778, USA
| | - Hiromi Sugiyama
- Radiation Effects Research Foundation, 5-2 Hijiyama Park, Minami-ku, Hiroshima 732-0815, Japan
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16 Street, 2 floor, San Francisco, CA 94143, USA
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Stokkevåg CH, Journy N, Vogelius IR, Howell RM, Hodgson D, Bentzen SM. Radiation Therapy Technology Advances and Mitigation of Subsequent Neoplasms in Childhood Cancer Survivors. Int J Radiat Oncol Biol Phys 2024; 119:681-696. [PMID: 38430101 DOI: 10.1016/j.ijrobp.2024.01.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/17/2023] [Accepted: 01/13/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE In this Pediatric Normal Tissue Effects in the Clinic (PENTEC) vision paper, challenges and opportunities in the assessment of subsequent neoplasms (SNs) from radiation therapy (RT) are presented and discussed in the context of technology advancement. METHODS AND MATERIALS The paper discusses the current knowledge of SN risks associated with historic, contemporary, and future RT technologies. Opportunities for research and SN mitigation strategies in pediatric patients with cancer are reviewed. RESULTS Present experience with radiation carcinogenesis is from populations exposed during widely different scenarios. Knowledge gaps exist within clinical cohorts and follow-up; dose-response and volume effects; dose-rate and fractionation effects; radiation quality and proton/particle therapy; age considerations; susceptibility of specific tissues; and risks related to genetic predisposition. The biological mechanisms associated with local and patient-level risks are largely unknown. CONCLUSIONS Future cancer care is expected to involve several available RT technologies, necessitating evidence and strategies to assess the performance of competing treatments. It is essential to maximize the utilization of existing follow-up while planning for prospective data collection, including standardized registration of individual treatment information with linkage across patient databases.
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Affiliation(s)
- Camilla H Stokkevåg
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway; Department of Physics and Technology, University of Bergen, Bergen, Norway.
| | - Neige Journy
- French National Institute of Health and Medical Research (INSERM) Unit 1018, Centre for Research in Epidemiology and Population Health, Paris Saclay University, Gustave Roussy, Villejuif, France
| | - Ivan R Vogelius
- Department of Clinical Oncology, Centre for Cancer and Organ Diseases and University of Copenhagen, Copenhagen, Denmark
| | - Rebecca M Howell
- Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas
| | - David Hodgson
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Center, Toronto, Ontario, Canada
| | - Søren M Bentzen
- Department of Epidemiology and Public Health, University of Maryland, Baltimore, Maryland
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4
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Kundi M. Letter to the editor. ENVIRONMENT INTERNATIONAL 2024; 187:108665. [PMID: 38677087 DOI: 10.1016/j.envint.2024.108665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024]
Abstract
Some have looked forward to the publication of the results of the COSMOS study on brain tumors, because the potential biases from retrospective investigations predominating the search for brain tumor risks of mobile phone use since the late 1990 s were deemed unresolvable by further investigations of that type. Indeed, prospective cohort studies typically have the advantage of being not or less affected by differential exposure misclassification, recall and selection bias, and, as they proceed in the direction of the time arrow, results are more easily interpreted in terms of causation. However, results of the COSMOS study published now in this journal are not of help for the risk assessment of mobile phone use and do not support the conclusions of the authors that their findings "suggest that the cumulative amount of mobile phone use is not associated with the risk of developing glioma, meningioma, or acoustic neuroma".
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Affiliation(s)
- Michael Kundi
- Medical University Vienna, Center for Public Health, Vienna, Austria
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Feychting M, Schüz J, Toledano MB, Vermeulen R, Auvinen A, Poulsen AH, Deltour I, Smith RB, Heller J, Kromhout H, Huss A, Johansen C, Tettamanti G, Elliott P. Response to the Letter to the Editor regarding "Mobile phone use and brain tumour risk - COSMOS, a prospective cohort study". ENVIRONMENT INTERNATIONAL 2024; 187:108664. [PMID: 38663236 DOI: 10.1016/j.envint.2024.108664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 05/19/2024]
Affiliation(s)
- Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Mireille B Toledano
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Medical Research Council (MRC) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; National Institute for Health Research (NIHR) Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, London, UK
| | - Roel Vermeulen
- Utrecht University, Institute for Risk Assessment Sciences, Utrecht, The Netherlands; University Medical Center Utrecht, Julius Center, The Netherlands
| | - Anssi Auvinen
- STUK - Radiation and Nuclear Safety Authority, Environmental Surveillance, Vantaa, Finland; Tampere University, Faculty of Social Sciences/Health Sciences, Tampere, Finland
| | | | - Isabelle Deltour
- International Agency for Research on Cancer (IARC/WHO), Environment and Lifestyle Epidemiology Branch, Lyon, France
| | - Rachel B Smith
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Medical Research Council (MRC) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; National Institute for Health Research (NIHR) Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK; Mohn Centre for Children's Health and Wellbeing, School of Public Health, Imperial College London, London, UK
| | - Joel Heller
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Hans Kromhout
- Utrecht University, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
| | - Anke Huss
- Utrecht University, Institute for Risk Assessment Sciences, Utrecht, The Netherlands
| | - Christoffer Johansen
- CASTLE Cancer Late Effect Research Oncology Clinic, Center for Surgery and Cancer, Rigshospitalet, Copenhagen, Denmark
| | - Giorgio Tettamanti
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Paul Elliott
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK; Medical Research Council (MRC) Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; National Institute for Health Research (NIHR) Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Imperial College London, London, UK; NIHR Imperial Biomedical Research Centre, Imperial College London, London, UK.
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Moseeva MB, Azizova TV, Bannikova MV. Risk of central nervous system tumour incidence in a cohort of workers chronically exposed to ionising radiation. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2024; 63:17-26. [PMID: 38212569 DOI: 10.1007/s00411-023-01054-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024]
Abstract
The aim of the present study was to assess the risk of primary central nervous system (CNS) tumour incidence in a cohort of 22,377 Mayak Production Association workers chronically exposed to ionising radiation. There were 96 primary CNS tumours, including 42 cases of glioma and 44 cases of meningioma, registered during the whole follow-up period (1948-2018). The study demonstrated that the risk of primary CNS tumour incidence was associated with sex, attained age, calendar period, tall body height, age at the beginning of exposure, and facility type. There was no association found between risk of CNS tumour incidence and body mass index, smoking (males) and alcohol consumption status. The study did not find an effect of the total external gamma radiation dose absorbed in the brain on risk of CNS tumour incidence irrespective of whether an adjustment for the total external neutron dose absorbed in the brain was included or not. Excess relative risk per 1 Gy of external gamma brain dose was 0.05 (95% confidence interval (CI) -0.30; 0.70) for all CNS tumours, -0.18 (95% CI -; 0.44) for gliomas, and 0.38 (95% CI -0.32; 2.08) for meningiomas without adjustment for total neutron brain dose. There was no effect modification by sex, attained age, age at hire or facility.
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Affiliation(s)
- Maria B Moseeva
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk Region, Russia
| | - Tamara V Azizova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk Region, Russia.
| | - Maria V Bannikova
- Clinical Department, Southern Urals Biophysics Institute (SUBI), Ozyorsk, Chelyabinsk Region, Russia
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7
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Cucinotta FA. Non-targeted effects and space radiation risks for astronauts on multiple International Space Station and lunar missions. LIFE SCIENCES IN SPACE RESEARCH 2024; 40:166-175. [PMID: 38245342 DOI: 10.1016/j.lssr.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/14/2023] [Accepted: 08/21/2023] [Indexed: 01/22/2024]
Abstract
Future space travel to the earth's moon or the planet Mars will likely lead to the selection of experienced International Space Station (ISS) or lunar crew persons for subsequent lunar or mars missions. Major concerns for space travel are galactic cosmic ray (GCR) risks of cancer and circulatory diseases. However large uncertainties in risk prediction occur due to the quantitative and qualitative differences in heavy ion microscopic energy deposition leading to differences in biological effects compared to low LET radiation. In addition, there are sparse radiobiology data and absence of epidemiology data for heavy ions and other high LET radiation. Non-targeted effects (NTEs) are found in radiobiology studies to increase the biological effectiveness of high LET radiation at low dose for cancer related endpoints. In this paper the most recent version of the NASA Space Cancer Risk model (NSCR-2022) is used to predict mission risks while considering NTEs in solid cancer risk predictions. I discuss predictions of space radiation risks of cancer and circulatory disease mortality for US Whites and US Asian-Pacific Islander (API) populations for 6-month ISS, 80-day lunar missions, and combined ISS-lunar mission. Model predictions suggest NTE increase cancer risks by about ∼2.3 fold over a model that ignores NTEs. US API are predicted to have a lower cancer risks of about 30% compared to US Whites. Cancer risks are slightly less than additive for multiple missions, which is due to the decease of risk with age of exposure and the increased competition with background risks as radiation risks increase. The inclusion of circulatory risks increases mortality estimates about 25% and 37% for females and males, respectively in the model ignoring NTEs, and 20% and 30% when NTEs are assumed to modify solid cancer risk. The predictions made here for combined ISS and lunar missions suggest risks are within risk limit recommendations by the National Council on Radiation Protection and Measurements (NCRP) for such missions.
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Affiliation(s)
- Francis A Cucinotta
- Univerity of Nevada Las Vegas, Las Vegas, NV, 89154, United States of America.
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8
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Cucinotta FA, Saganti PB. Residual radiation risk disparities across sex and race or ethnic groups for lifetime never-smokers on lunar missions. LIFE SCIENCES IN SPACE RESEARCH 2024; 40:72-80. [PMID: 38245350 DOI: 10.1016/j.lssr.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 01/22/2024]
Abstract
Missions to the Earth's moon are of scientific and societal interest, however pose the problem of risks of late effects for returning crew persons, most importantly cancer and circulatory diseases. In this paper, we discuss NSCR-2022 model risk estimates for lunar missions for US racial and ethnic groups comparing never-smokers (NS) to US averages for each group and sex. We show that differences within groups between men and women are reduced for NS compared to the average population. Race and ethnic group dependent cancer and circulatory disease risks are reduced by 10% to 40% for NS with the largest decrease for Whites. Circulatory disease risks are changed by less than 10% for NS and in several cases modestly increased due to increased lifespan for NS. Asian-Pacific Islanders (API) and Hispanics NS are at lower risk compared to Whites and Blacks. Differences between groups are narrowed for NS compared to predictions for average populations, however disparities remain especially for Blacks and to a lesser extent Whites compared to API or Hispanic NS groups.
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Affiliation(s)
- Francis A Cucinotta
- Department of Health Physics and Diagnostic Sciences, University of Nevada, Las Vegas, NV, United States of America.
| | - Premkumar B Saganti
- Department of Physics, Prairie View A&M University, Prairie View, TX, United States of America
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9
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Milder CM, Howard SC, Ellis ED, Golden AP, Cohen SS, Mumma MT, Leggett RW, French B, Zablotska LB, Boice JD. Third mortality follow-up of the Mallinckrodt uranium processing workers, 1942-2019. Int J Radiat Biol 2024; 100:161-175. [PMID: 37819879 PMCID: PMC10843089 DOI: 10.1080/09553002.2023.2267640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
INTRODUCTION Mallinckrodt Chemical Works was a uranium processing facility during the Manhattan Project from 1942 to 1966. Thousands of workers were exposed to low-dose-rates of ionizing radiation from external and internal sources. This third follow-up of 2514 White male employees updates cancer and noncancer mortality potentially associated with radiation and silica dust. MATERIALS AND METHODS Individual, annualized organ doses were estimated from film badge records (n monitored = 2514), occupational chest x-rays (n = 2514), uranium urinalysis (n = 1868), radium intake through radon breath measurements (n = 487), and radon ambient measurements (n = 1356). Silica dust exposure from pitchblende processing was estimated (n = 1317). Vital status and cause of death determination through 2019 relied upon the National Death Index and Social Security Administration Epidemiological Vital Status Service. The analysis included standardized mortality ratios (SMRs), Cox proportional hazards, and Poisson regression models. RESULTS Vital status was confirmed for 99.4% of workers (84.0% deceased). For a dose weighting factor of 1 for intakes of uranium, radium, and radon decay products, the mean and median lung doses were 65.6 and 29.9 mGy, respectively. SMRs indicated a difference in health outcomes between salaried and hourly workers, and more brain cancer deaths than expected [SMR: 1.79; 95% confidence interval (CI): 1.14, 2.70]. No association was seen between radiation and lung cancer [hazard ratio (HR) at 100 mGy: 0.93; 95%CI: 0.78, 1.11]. The relationship between radiation and kidney cancer observed in the previous follow-up was maintained (HR at 100 mGy: 2.07; 95%CI: 1.12, 3.79). Cardiovascular disease (CVD) also increased significantly with heart dose (HR at 100 mGy: 1.11; 95%CI: 1.02, 1.21). Exposures to dust ≥23.6 mg/m3-year were associated with nonmalignant kidney disease (NMKD) (HR: 3.02; 95%CI: 1.12, 8.16) and kidney cancer combined with NMKD (HR: 2.46; 95%CI: 1.04, 5.81), though without evidence of a dose-response per 100 mg/m3-year. CONCLUSIONS This third follow-up of Mallinckrodt uranium processors reinforced the results of the previous studies. There was an excess of brain cancers compared with the US population, although no radiation dose-response was detected. The association between radiation and kidney cancer remained, though potentially due to few cases at higher doses. The association between levels of silica dust ≥23.6 mg/m3-year and NMKD also remained. No association was observed between radiation and lung cancer. A positive dose-response was observed between radiation and CVD; however, this association may be confounded by smoking, which was unmeasured. Future work will pool these data with other uranium processing worker cohorts within the Million Person Study.
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Affiliation(s)
- Cato M. Milder
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute
| | | | | | | | - Sarah S. Cohen
- EpidStrategies, a Division of ToxStrategies, Inc., Katy, TX
| | | | | | - Benjamin French
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA
| | - John D. Boice
- Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, USA
- National Council on Radiation Protection and Measurements (NCRP), Bethesda, MD, USA
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10
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Thariat J, Little MP, Zablotska LB, Samson P, O’Banion MK, Leuraud K, Bergom C, Girault G, Azimzadeh O, Bouffler S, Hamada N. Radiotherapy for non-cancer diseases: benefits and long-term risks. Int J Radiat Biol 2024; 100:505-526. [PMID: 38180039 PMCID: PMC11039429 DOI: 10.1080/09553002.2023.2295966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024]
Abstract
PURPOSE The discovery of X-rays was followed by a variety of attempts to treat infectious diseases and various other non-cancer diseases with ionizing radiation, in addition to cancer. There has been a recent resurgence of interest in the use of such radiotherapy for non-cancer diseases. Non-cancer diseases for which use of radiotherapy has currently been proposed include refractory ventricular tachycardia, neurodegenerative diseases (e.g. Alzheimer's disease and dementia), and Coronavirus Disease 2019 (COVID-19) pneumonia, all with ongoing clinical studies that deliver radiation doses of 0.5-25 Gy in a single fraction or in multiple daily fractions. In addition to such non-cancer effects, historical indications predominantly used in some countries (e.g. Germany) include osteoarthritis and degenerative diseases of the bones and joints. This narrative review gives an overview of the biological rationale and ongoing preclinical and clinical studies for radiotherapy proposed for various non-cancer diseases, discusses the plausibility of the proposed biological rationale, and considers the long-term radiation risks of cancer and non-cancer diseases. CONCLUSIONS A growing body of evidence has suggested that radiation represents a double-edged sword, not only for cancer, but also for non-cancer diseases. At present, clinical evidence has shown some beneficial effects of radiotherapy for ventricular tachycardia, but there is little or no such evidence of radiotherapy for other newly proposed non-cancer diseases (e.g. Alzheimer's disease, COVID-19 pneumonia). Patients with ventricular tachycardia and COVID-19 pneumonia have thus far been treated with radiotherapy when they are an urgent life threat with no efficient alternative treatment, but some survivors may encounter a paradoxical situation where patients were rescued by radiotherapy but then get harmed by radiotherapy. Further studies are needed to justify the clinical use of radiotherapy for non-cancer diseases, and optimize dose to diseased tissue while minimizing dose to healthy tissue.
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Affiliation(s)
- Juliette Thariat
- Department of Radiation Oncology, Comprehensive Cancer Centre François Baclesse, Caen, France
- Laboratoire de Physique Corpusculaire IN2P3, ENSICAEN/CNRS UMR 6534, Normandie Université, Caen, France
| | - Mark P. Little
- Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland, USA
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Pamela Samson
- Department of Radiation Oncology, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - M. Kerry O’Banion
- Department of Neuroscience, Del Monte Institute for Neuroscience, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Klervi Leuraud
- Research Department on Biological and Health Effects of Ionizing Radiation (SESANE), Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Carmen Bergom
- Department of Radiation Oncology, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri, USA
- Cardio-Oncology Center of Excellence, Washington University, St. Louis, Missouri, USA
| | - Gilles Girault
- Comprehensive Cancer Centre François Baclesse, Medical Library, Caen, France
| | - Omid Azimzadeh
- Federal Office for Radiation Protection (BfS), Section Radiation Biology, Neuherberg, Germany
| | - Simon Bouffler
- Radiation Protection Sciences Division, UK Health Security Agency (UKHSA), Chilton, Didcot, UK
| | - Nobuyuki Hamada
- Biology and Environmental Chemistry Division, Sustainable System Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Abiko, Chiba, Japan
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11
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Macedo C, Costa PC, Rodrigues F. Bioactive compounds from Actinidia arguta fruit as a new strategy to fight glioblastoma. Food Res Int 2024; 175:113770. [PMID: 38129059 DOI: 10.1016/j.foodres.2023.113770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 11/10/2023] [Accepted: 11/22/2023] [Indexed: 12/23/2023]
Abstract
In recent years, there has been a significant demand for natural products as a mean of disease prevention or as an alternative to conventional medications. The driving force for this change is the growing recognition of the abundant presence of valuable bioactive compounds in natural products. On recent years Actinia arguta fruit, also known as kiwiberry, has attracted a lot of attention from scientific community due to its richness in bioactive compounds, including phenolic compounds, organic acids, vitamins, carotenoids and fiber. These bioactive compounds contribute to the fruit's diverse outstanding biological activities such as antioxidant, anti-inflammatory, neuroprotective, immunomodulatory, and anti-cancer properties. Due to these properties, the fruit may have the potential to be used in the treatment/prevention of various types of cancer, including glioblastoma. Glioblastoma is the most aggressive form of brain cancer, displaying 90 % of recurrence rate within a span of 2 years. Despite the employment of an aggressive approach, the prognosis remains unfavorable, emphasizing the urgent requirement for the development of new effective treatments. The preclinical evidence suggests that kiwiberry has potential impact on glioblastoma by reducing the cancer self-renewal, modulating the signaling pathways involved in the regulation of the cell phenotype and metabolism, and influencing the consolidation of the tumor microenvironment. Even though, challenges such as the imprecise composition and concentration of bioactive compounds, and its low bioavailability after oral administration may be drawbacks to the development of kiwiberry-based treatments, being urgent to ensure the safety and efficacy of kiwiberry for the prevention and treatment of glioblastoma. This review aims to highlight the potential impact of A. arguta bioactive compounds on glioblastoma, providing novel insights into their applicability as complementary or alternative therapies.
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Affiliation(s)
- Catarina Macedo
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal; REQUIMTE/UCIBIO, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal
| | - Paulo C Costa
- REQUIMTE/UCIBIO, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Rua de Jorge Viterbo Ferreira, 228, 4050-313 Porto, Portugal; Associate Laboratory i4HB-Institute for Health and Bioeconomy, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal.
| | - Francisca Rodrigues
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 4249-015 Porto, Portugal.
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12
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Gu Y, Wang J, Wang Y, Xu C, Liu Y, Du L, Wang Q, Ji K, He N, Zhang M, Song H, Niu K, Liu Q. Association of low-dose ionising radiation with site-specific solid cancers: Chinese medical X-ray workers cohort study, 1950-1995. Occup Environ Med 2023; 80:687-693. [PMID: 37918914 DOI: 10.1136/oemed-2023-108875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND The dose-response relationship between cancers and protracted low-dose rate exposure to ionising radiation is still uncertain. This study aims to estimate quantified relationships between low-dose radiation exposures and site-specific solid cancers among Chinese medical X-ray workers. METHODS This cohort study included 27 011 individuals who were employed at major hospitals in 24 provinces in China from 1950 to 1980 and had been exposed to X-ray equipment, and a control group of 25 782 physicians who were not exposed to X-ray equipment. Person-years of follow-up were calculated from the year of employment to the date of the first diagnosis of cancer or the end of follow-up, whichever occurred first. All cancers were obtained from medical records during 1950-1995. This study used Poisson regression models to estimate the excess relative risk (ERR) and excess absolute risk (EAR) for incidence of site-specific solid cancers associated with cumulative dose. RESULTS 1643 solid cancers were developed, the most common being lung, liver and stomach cancer. Among X-ray workers, the average cumulative colon dose was 0.084 Gy. We found a positive relationship between cumulative organ-specific dose and liver (ERR/Gy=1.48; 95% CI 0.40 to 2.83), oesophagus (ERR/Gy=18.1; 95% CI 6.25 to 39.1), thyroid (ERR/Gy=2.96; 95% CI 0.44 to 8.18) and non-melanoma skin cancers (ERR/Gy=7.96; 95% CI 2.13 to 23.12). We found no significant relationship between cumulative organ-specific doses and other cancers. Moreover, the results showed a statistically significant EAR for liver, stomach, breast cancer (female), thyroid and non-melanoma skin cancers. CONCLUSIONS These findings provided more useful insights into the risks of site-specific cancers from protracted low-dose rate exposure to ionising radiation.
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Affiliation(s)
- Yeqing Gu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Jinhan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Chang Xu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Yang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Liqing Du
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Qin Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaihua Ji
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Ningning He
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Manman Zhang
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Huijuan Song
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
| | - Kaijun Niu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
- School of Public Health of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Qiang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College Institute of Radiation Medicine, Tianjin, China
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13
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Ekqvist O, Raitanen J, Auvinen A. Changes in incidence trends of meningioma in Finland, 1990-2017: analysis of Finnish Cancer Registry data. Acta Oncol 2023; 62:994-1000. [PMID: 37669182 DOI: 10.1080/0284186x.2023.2245554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/14/2023] [Indexed: 09/07/2023]
Abstract
BACKGROUND Meningiomas are the most common primary neoplasm of the central nervous system. Previous research on the incidence of meningioma in Finland showed an increase in the age-standardized incidence rate over three decades (1968-1997). In this study, we analysed meningioma incidence in Finland during 1990-2017. MATERIALS AND METHODS Data on 9842 meningioma patients were obtained from the Finnish Cancer Registry, and population size by calendar year, sex, and age group from Statistics Finland. The European Standard Population was used to calculate age-standardized incidence rates. Poisson regression was used to evaluate differences by sex and age, and joinpoint regression to examine changes in trend. RESULTS At the beginning of the study period, the age-standardized incidence of meningioma for men was 2.35/100,000 and for women 6.96/100,000. In the end, it was 4.09/100,000 and 10.19/100,000, respectively. The annual percent change (APC) for women was +4.6 (95% confidence interval, CI 3.10 to 6.20) from 1990 to 2001 and -1.0 (95% CI -1.70 to -0.30) from 2001 to 2017. For men, the APC was +3.1 (95% CI 0.80-5.40) during 1990-2002 and -0.9 (95% CI -2.10 to 0.30) in 2002-2017. The incidence of meningioma in women was 2.8 times higher than in men (rate ratio 2.81; 95% CI 2.68-2.94). CONCLUSIONS Meningioma incidence increased in both sexes from 1990, but the trend reversed in 2001-2002. Medical imaging or risk factors do not appear to explain the changes.
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Affiliation(s)
- Olli Ekqvist
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Jani Raitanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- UKK Institute for Health Promotion Research, Tampere, Finland
| | - Anssi Auvinen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- STUK-Radiation and Nuclear Safety Authority, Vantaa, Finland
- FICAN Mid Regional Cancer Center, Tampere, Finland
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14
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Laurier D, Billarand Y, Klokov D, Leuraud K. The scientific basis for the use of the linear no-threshold (LNT) model at low doses and dose rates in radiological protection. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2023; 43:024003. [PMID: 37339605 DOI: 10.1088/1361-6498/acdfd7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/20/2023] [Indexed: 06/22/2023]
Abstract
The linear no-threshold (LNT) model was introduced into the radiological protection system about 60 years ago, but this model and its use in radiation protection are still debated today. This article presents an overview of results on effects of exposure to low linear-energy-transfer radiation in radiobiology and epidemiology accumulated over the last decade and discusses their impact on the use of the LNT model in the assessment of radiation-related cancer risks at low doses. The knowledge acquired over the past 10 years, both in radiobiology and epidemiology, has reinforced scientific knowledge about cancer risks at low doses. In radiobiology, although certain mechanisms do not support linearity, the early stages of carcinogenesis comprised of mutational events, which are assumed to play a key role in carcinogenesis, show linear responses to doses from as low as 10 mGy. The impact of non-mutational mechanisms on the risk of radiation-related cancer at low doses is currently difficult to assess. In epidemiology, the results show excess cancer risks at dose levels of 100 mGy or less. While some recent results indicate non-linear dose relationships for some cancers, overall, the LNT model does not substantially overestimate the risks at low doses. Recent results, in radiobiology or in epidemiology, suggest that a dose threshold, if any, could not be greater than a few tens of mGy. The scientific knowledge currently available does not contradict the use of the LNT model for the assessment of radiation-related cancer risks within the radiological protection system, and no other dose-risk relationship seems more appropriate for radiological protection purposes.
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Affiliation(s)
- Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Yann Billarand
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Institute for Radiological Protection and Nuclear Safety (IRSN), Fontenay-aux-Roses, France
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15
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Degeneffe A, De Maertelaer V, De Witte O, Lefranc F. The Association Between Meningioma and Breast Cancer: A Systematic Review and Meta-analysis. JAMA Netw Open 2023; 6:e2318620. [PMID: 37326990 PMCID: PMC10276307 DOI: 10.1001/jamanetworkopen.2023.18620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/02/2023] [Indexed: 06/17/2023] Open
Abstract
Importance A potential relationship between meningioma and breast cancer was suggested 70 years ago. However, to date, no conclusive evidence is available on this topic. Objective To provide a comprehensive review of the literature on the association of meningioma with breast cancer, supported by a meta-analysis. Data Sources A systematic PubMed search was performed up to April 2023 to identify articles on the association of meningioma with breast cancer. The following key words were used strategically: meningioma, breast cancer, breast carcinoma, association, relation. Study Selection All studies reporting women diagnosed with meningioma and breast cancer were identified. The search strategy was not limited by study design or publication date but only included articles in English. Additional articles were identified via citation searching. Studies reporting a complete population of meningiomas or breast cancer patients throughout a specific study period and a proportion of patients with a second pathology could be used for the meta-analysis. Data Extraction and Synthesis Data extraction was performed by 2 authors in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) statement. Meta-analyses regarding both populations were performed using a random-effects model. Risk of bias was assessed. Main Outcomes and Measures The main measures were whether there was an increased prevalence of breast cancer in female patients with meningioma and whether there was an increased prevalence of meningioma in female patients with breast cancer. Results A total of 51 retrospective studies (case reports, case series, and cancer registry reports) describing 2238 patients with both diseases were identified; 18 studies qualified for prevalence analyses and meta-analysis. The random-effects meta-analysis (13 studies) revealed a significantly greater prevalence of breast cancer in female patients with meningioma than in the overall population (odds ratio [OR], 9.87; 95% CI, 7.31-13.32). Meningioma incidence in patients with breast cancer (11 studies) was greater than that in the baseline population; however, the difference according to the random-effects model was not statistically significant (OR, 1.41; 95% CI, 0.99-2.02). Conclusions and Relevance This large systematic review and the meta-analysis on the association between meningioma and breast cancer found nearly 10-fold higher odds of breast cancer in female patients with meningioma compared with the general female population. These findings suggest that female patients with meningioma should be screened more intensively for breast cancer. Further research is required to identify the factors causing this association.
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Affiliation(s)
- Aurélie Degeneffe
- Department of Neurosurgery, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Viviane De Maertelaer
- Biostatistical Unit, Institute of Interdisciplinary Research in Human and Molecular Biology, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Olivier De Witte
- Department of Neurosurgery, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
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Maeda Y, Onishi S, Yamasaki F, Takayasu T, Yonezawa U, Taguchi A, Horie N. Secondary meningioma after cranial irradiation: case series and comprehensive literature review. Jpn J Clin Oncol 2023; 53:212-220. [PMID: 36524362 DOI: 10.1093/jjco/hyac191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 11/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Secondary meningioma after cranial irradiation, so-called radiation-induced meningioma, is one of the important late effects after cranial radiation therapy. In this report, we analyzed our case series of secondary meningioma after cranial irradiation and conducted a critical review of literature to reveal the characteristics of secondary meningioma. MATERIALS AND METHODS We performed a comprehensive literature review by using Pubmed, MEDLINE and Google scholar databases and investigated pathologically confirmed individual cases. In our institute, we found pathologically diagnosed seven cases with secondary meningioma between 2000 and 2018. Totally, 364 cases were analyzed based on gender, WHO grade, radiation dose, chemotherapy. The latency years from irradiation to development of secondary meningioma were analyzed with Kaplan-Meier analysis. Spearman's correlation test was used to determine the relationship between age at irradiation and the latency years. RESULTS The mean age at secondary meningioma development was 35.6 ± 15.7 years and the mean latency periods were 22.6 ± 12.1 years. The latency periods from irradiation to the development of secondary meningioma are significantly shorter in higher WHO grade group (P = 0.0026, generalized Wilcoxon test), higher radiation dose group (P < 0.0001) and concomitant systemic chemotherapy group (P = 0.0003). Age at irradiation was negatively associated with the latency periods (r = -0.23231, P < 0.0001, Spearman's correlation test). CONCLUSION Cranial irradiation at older ages, at higher doses and concomitant chemotherapy was associated with a shorter latency period to develop secondary meningiomas. However, even low-dose irradiation can cause secondary meningiomas after a long latency period. Long-term follow-up is necessary to minimize the morbidity and mortality caused by secondary meningioma after cranial irradiation.
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Affiliation(s)
- Yugo Maeda
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.,Department of Neurosurgery, Miyoshi Municipal Central Hospital, Hiroshima, Japan
| | - Shumpei Onishi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ushio Yonezawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akira Taguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Gupta U, Baig S, Majid A, Bell SM. The neurology of space flight; How does space flight effect the human nervous system? LIFE SCIENCES IN SPACE RESEARCH 2023; 36:105-115. [PMID: 36682819 DOI: 10.1016/j.lssr.2022.09.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 06/17/2023]
Abstract
RATIONALE AND HYPOTHESIS Advancements in technology, human adaptability, and funding have increased space exploration and in turn commercial spaceflight. Corporations such as Space X and Blue Origin are exploring methods to make space tourism possible. This could lead to an increase in the number of patients presenting with neurological diseases associated with spaceflight. Therefore, a comprehensive understanding of spaceflight stressors is required to manage neurological disease in high-risk individuals. OBJECTIVES This review aims to describe the neurological effects of spaceflight and to assess countermeasures such as pre-flight prophylaxis, training, and possible therapeutics to reduce long-term effects. METHODOLOGY A literature search was performed for experimental studies conducted in astronauts and in animal models that simulated the space environment. Many studies, however, only discussed these with scientific reasoning and did not include any experimental methods. Relevant studies were identified through searching research databases such as PubMed and Google Scholar. No inclusion or exclusion criteria were used. FINDINGS Analysis of these studies provided a holistic understanding of the acute and chronic neurological changes that occur during space flight. Astronauts are exposed to hazards that include microgravity, cosmic radiation, hypercapnia, isolation, confinement and disrupted circadian rhythms. Microgravity, the absence of a gravitational force, is linked to disturbances in the vestibular system, intracranial and intraocular pressures. Furthermore, microgravity affects near field vision as part of the spaceflight-associated neuro-ocular syndrome. Exposure to cosmic radiation can increase the risk of neurodegenerative conditions and malignancies. It is estimated that cosmic radiation has significantly higher ionising capabilities than the ionising radiation used in medicine. Space travel also has potential benefits to the nervous system, including psychological development and effects on learning and memory. Future work needs to focus on how we can compare a current astronaut to a future space tourist. Potentially the physiological and psychological stresses of space flight might lead to neurological complications in future space travellers that do not have the physiological reserve of current astronauts.
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Affiliation(s)
- Udit Gupta
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, 385a Glossop Road, Sheffield and S10 2HQ, United Kingdom
| | - Sheharyar Baig
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, 385a Glossop Road, Sheffield and S10 2HQ, United Kingdom; Department of Clinical Neurology, Royal Hallamshire Hospital, Glossop Road, Sheffield, United Kingdom
| | - Arshad Majid
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, 385a Glossop Road, Sheffield and S10 2HQ, United Kingdom; Department of Clinical Neurology, Royal Hallamshire Hospital, Glossop Road, Sheffield, United Kingdom
| | - Simon M Bell
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, 385a Glossop Road, Sheffield and S10 2HQ, United Kingdom; Department of Clinical Neurology, Royal Hallamshire Hospital, Glossop Road, Sheffield, United Kingdom.
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18
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Hauptmann M, Byrnes G, Cardis E, Bernier MO, Blettner M, Dabin J, Engels H, Istad TS, Johansen C, Kaijser M, Kjaerheim K, Journy N, Meulepas JM, Moissonnier M, Ronckers C, Thierry-Chef I, Le Cornet L, Jahnen A, Pokora R, Bosch de Basea M, Figuerola J, Maccia C, Nordenskjold A, Harbron RW, Lee C, Simon SL, Berrington de Gonzalez A, Schüz J, Kesminiene A. Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study. Lancet Oncol 2023; 24:45-53. [PMID: 36493793 DOI: 10.1016/s1470-2045(22)00655-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The European EPI-CT study aims to quantify cancer risks from CT examinations of children and young adults. Here, we assess the risk of brain cancer. METHODS We pooled data from nine European countries for this cohort study. Eligible participants had at least one CT examination before age 22 years documented between 1977 and 2014, had no previous diagnosis of cancer or benign brain tumour, and were alive and cancer-free at least 5 years after the first CT. Participants were identified through the Radiology Information System in 276 hospitals. Participants were linked with national or regional registries of cancer and vital status, and eligible cases were patients with brain cancers according to WHO International Classification of Diseases for Oncology. Gliomas were analysed separately to all brain cancers. Organ doses were reconstructed using historical machine settings and a large sample of CT images. Excess relative risks (ERRs) of brain cancer per 100 mGy of cumulative brain dose were calculated with linear dose-response modelling. The outcome was the first reported diagnosis of brain cancer after an exclusion period of 5 years after the first electronically recorded CT examination. FINDINGS We identified 948 174 individuals, of whom 658 752 (69%) were eligible for our study. 368 721 (56%) of 658 752 participants were male and 290 031 (44%) were female. During a median follow-up of 5·6 years (IQR 2·4-10·1), 165 brain cancers occurred, including 121 (73%) gliomas. Mean cumulative brain dose, lagged by 5 years, was 47·4 mGy (SD 60·9) among all individuals and 76·0 mGy (100·1) among people with brain cancer. A significant linear dose-response relationship was observed for all brain cancers (ERR per 100 mGy 1·27 [95% CI 0·51-2·69]) and for gliomas separately (ERR per 100 mGy 1·11 [0·36-2·59]). Results were robust when the start of follow-up was delayed beyond 5 years and when participants with possibly previously unreported cancers were excluded. INTERPRETATION The observed significant dose-response relationship between CT-related radiation exposure and brain cancer in this large, multicentre study with individual dose evaluation emphasises careful justification of paediatric CTs and use of doses as low as reasonably possible. FUNDING EU FP7; Belgian Cancer Registry; La Ligue contre le Cancer, L'Institut National du Cancer, France; Ministry of Health, Labour and Welfare of Japan; German Federal Ministry of Education and Research; Worldwide Cancer Research; Dutch Cancer Society; Research Council of Norway; Consejo de Seguridad Nuclear, Generalitat de Catalunya, Spain; US National Cancer Institute; UK National Institute for Health Research; Public Health England.
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Affiliation(s)
- Michael Hauptmann
- Institute of Biostatistics and Registry Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany.
| | - Graham Byrnes
- International Agency for Research on Cancer (IARC/WHO), Environmental and Lifestyle Epidemiology Branch, Lyon, France
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Marie-Odile Bernier
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
| | - Maria Blettner
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jérémie Dabin
- Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Hilde Engels
- Belgian Nuclear Research Centre (SCK CEN), Mol, Belgium
| | - Tore S Istad
- Norwegian Radiation and Nuclear Safety Authority, Oslo, Norway
| | - Christoffer Johansen
- Cancer Late Effect Research Oncology Clinic (CASTLE), Center for Surgery and Cancer, Rigshospitalet, Copenhagen, Denmark
| | - Magnus Kaijser
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Neige Journy
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France; French National Institute of Health and Medical Research (Inserm), U1018, Centre for Research in Epidemiology and Population Health (CESP), Radiation Epidemiology Group, Gustave Roussy, Paris-Saclay, Paris-Sud University, Gustave Roussy, Villejuif, France
| | | | - Monika Moissonnier
- International Agency for Research on Cancer (IARC/WHO), Environmental and Lifestyle Epidemiology Branch, Lyon, France
| | - Cecile Ronckers
- Institute of Biostatistics and Registry Research, Faculty of Health Sciences Brandenburg, Brandenburg Medical School, Neuruppin, Germany
| | - Isabelle Thierry-Chef
- International Agency for Research on Cancer (IARC/WHO), Environmental and Lifestyle Epidemiology Branch, Lyon, France; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Lucian Le Cornet
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Cancer Research Center, Heidelberg, Germany
| | - Andreas Jahnen
- Luxembourg Institute of Science and Technology (LIST), Esch-sur-Alzette, Luxembourg
| | - Roman Pokora
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Magda Bosch de Basea
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Jordi Figuerola
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Carlo Maccia
- CAATS, Centre d'Assurance de qualité des Applications Technologiques dans le domaine de la Santé, Sèvres, France
| | - Arvid Nordenskjold
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Richard W Harbron
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Choonsik Lee
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Steven L Simon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Amy Berrington de Gonzalez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Environmental and Lifestyle Epidemiology Branch, Lyon, France
| | - Ausrele Kesminiene
- International Agency for Research on Cancer (IARC/WHO), Environmental and Lifestyle Epidemiology Branch, Lyon, France
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Withrow DR, Anderson H, Armstrong GT, Hawkins M, Journy N, Neglia JP, de Vathaire F, Tucker MA, Inskip PD, Brenner AV, Stovall MA, Diallo I, Berrington de Gonzalez A, Veiga LHS. Pooled Analysis of Meningioma Risk Following Treatment for Childhood Cancer. JAMA Oncol 2022; 8:1756-1764. [PMID: 36201196 PMCID: PMC9539736 DOI: 10.1001/jamaoncol.2022.4425] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Importance Meningioma is the most common subsequent neoplasm following cranial irradiation among survivors of childhood cancer, but there are still uncertainties regarding the magnitude of the radiation dose-response association, potential modifiers of radiation risks, and the role of chemotherapy. Objective To evaluate meningioma risk in survivors of childhood cancer following radiotherapy and chemotherapy and identify possible modifying factors of radiation-associated risk. Design, Setting, and Participants This international case-control study pooled data from 4 nested case-control studies of survivors of childhood cancer diagnosed between 1942 and 2000, followed through 2016. Cases were defined as participants diagnosed with a subsequent meningioma. Controls were matched to cases based on sex, age at first cancer diagnosis, and duration of follow-up. Data were analyzed from July 2019 to June 2022. Exposures Radiation dose (Gy) to the meningioma site and cumulative chemotherapy doses, including intrathecal and systemic methotrexate doses. Main Outcomes and Measures The main outcome was subsequent meningioma, assessed using odds ratios (ORs) and excess odds ratios per gray (EOR/Gy). Results The analysis included 273 survivors of childhood cancer who developed meningioma (cases) and 738 survivors who did not (controls), with a total of 1011 individuals (median [IQR] age at first cancer diagnosis 5.0 [3.0-9.2] years; 599 [59.2%] female). Median (IQR) time since first cancer was 21.5 (15.0-27.0) years. Increasing radiation dose was associated with increased risk of meningioma (EOR/Gy, 1.44; 95% CI, 0.62-3.61), and there was no evidence of departure from linearity (P = .90). Compared with survivors who were not exposed to radiation therapy, those who received doses of 24 Gy or more had more than 30-fold higher odds of meningioma (OR, 33.66; 95% CI, 14.10-80.31). The radiation dose-response association was significantly lower among patients treated at age 10 years or older compared with those treated before age 10 years (EOR/Gy, 0.57; 95% CI, 0.18-1.91 vs 2.20; 95% CI, 0.87-6.31; P for heterogeneity = .03). Risk associated with radiation remained significantly elevated 30 years after exposure (EOR/Gy, 3.76; 95% CI, 0.77-29.15). We found an increased risk of meningioma among children who had received methotrexate (OR, 3.43; 95% CI, 1.56-7.57), but no evidence of a dose-response association or interaction with radiation dose. Conclusions and Relevance These findings suggest that the meninges are highly radiosensitive, especially for children treated before age 10 years. These results support the reduction in whole-brain irradiation over recent decades and the prioritization of approaches that limit radiation exposure in healthy tissue for children. The persistence of elevated risks of meningiomas for 30 years after cranial radiotherapy could help inform surveillance guidelines.
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Affiliation(s)
- Diana R. Withrow
- Nuffield Department of Primary Care Health Sciences, Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Harald Anderson
- Representing the Nordic Countries Childhood Survival Group, Department of Cancer Epidemiology, Lund University, Lund, Sweden
| | - Gregory T. Armstrong
- Epidemiology and Cancer Control Department, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Michael Hawkins
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, The Robert Aitken Institute for Clinical Research Building, Birmingham, United Kingdom
| | - Neige Journy
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Laboratory of Radiation Epidemiology & Cancer Survivorship Research, Paris-Saclay / Paris-Sud University, Gustave Roussy Cancer Campus, Villejuif, France
| | - Joseph P. Neglia
- Department of Pediatrics, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Florent de Vathaire
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Laboratory of Radiation Epidemiology & Cancer Survivorship Research, Paris-Saclay / Paris-Sud University, Gustave Roussy Cancer Campus, Villejuif, France
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Peter D. Inskip
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | | | | | - Ibrahima Diallo
- INSERM U1018, Centre for Research in Epidemiology and Population Health, Laboratory of Radiation Epidemiology & Cancer Survivorship Research, Paris-Saclay / Paris-Sud University, Gustave Roussy Cancer Campus, Villejuif, France
| | - Amy Berrington de Gonzalez
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Lene H. S. Veiga
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
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20
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Mo Z, Xin J, Chai R, Woo PY, Chan DT, Wang J. Epidemiological characteristics and genetic alterations in adult diffuse glioma in East Asian populations. Cancer Biol Med 2022; 19:j.issn.2095-3941.2022.0418. [PMID: 36350002 PMCID: PMC9630523 DOI: 10.20892/j.issn.2095-3941.2022.0418] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/20/2022] [Indexed: 05/06/2024] Open
Abstract
Understanding the racial specificities of diseases-such as adult diffuse glioma, the most common primary malignant tumor of the central nervous system-is a critical step toward precision medicine. Here, we comprehensively review studies of gliomas in East Asian populations and other ancestry groups to clarify the racial differences in terms of epidemiology and genomic characteristics. Overall, we observed a lower glioma incidence in East Asians than in Whites; notably, patients with glioblastoma had significantly younger ages of onset and longer overall survival than the Whites. Multiple genome-wide association studies of various cohorts have revealed single nucleotide polymorphisms associated with overall and subtype-specific glioma susceptibility. Notably, only 3 risk loci-5p15.33, 11q23.3, and 20q13.33-were shared between patients with East Asian and White ancestry, whereas other loci predominated only in particular populations. For instance, risk loci 12p11.23, 15q15-21.1, and 19p13.12 were reported in East Asians, whereas risk loci 8q24.21, 1p31.3, and 1q32.1 were reported in studies in White patients. Although the somatic mutational profiles of gliomas between East Asians and non-East Asians were broadly consistent, a lower incidence of EGFR amplification in glioblastoma and a higher incidence of 1p19q-IDH-TERT triple-negative low-grade glioma were observed in East Asian cohorts. By summarizing large-scale disease surveillance, germline, and somatic genomic studies, this review reveals the unique characteristics of adult diffuse glioma among East Asians, to guide clinical management and policy design focused on patients with East Asian ancestry.
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Affiliation(s)
- Zongchao Mo
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
- HKUST Shenzhen-Hong Kong Collaborative Innovation Research Institute, Shenzhen 518000, China
| | - Junyi Xin
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
| | - Ruichao Chai
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
- Department of Molecular Neuropathology, Beijing Neurosurgical Institute, Capital Medical University, Beijing 100070, China
| | - Peter Y.M. Woo
- Department of Neurosurgery, Kwong Wah Hospital, Hong Kong SAR, China
- Hong Kong Neuro-Oncology Society, Hong Kong SAR, China
| | - Danny T.M. Chan
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, Hong Kong SAR, China
| | - Jiguang Wang
- Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
- HKUST Shenzhen-Hong Kong Collaborative Innovation Research Institute, Shenzhen 518000, China
- Department of Chemical and Biological Engineering, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong SAR, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park, Hong Kong SAR, China
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21
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grabowicz W, Masiarek K, Górnik T, Grycewicz T, Brodecki M, Dabin J, Huet C, Vanhavere F, Domienik-Andrzejewska JK. The effect of lead free cap on the doses of ionizing radiation to the head of interventional cardiologists working in haemodynamic room. Int J Occup Med Environ Health 2022; 35:549-560. [PMID: 35446304 PMCID: PMC10464785 DOI: 10.13075/ijomeh.1896.01958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/01/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The study aim was to analyse the influence of the lead free cap on doses received by interventional cardiologists. The impact of lead free cap on doses to the head were evaluated in number of studies. As different methods used to assess the attenuation properties of protective cap can lead to ambiguous results, a detailed study was performed. MATERIAL AND METHODS The effectiveness of a lead free cap in reducing the doses to the skin was assessed in clinic by performing measurements with thermoluminescent dosimeters attached inside and outside the cap first during individual coronary angiography (CA) or CA/percutaneous transluminal coronary angioplasty (CA/PTCA) procedures and then cumulated during few procedures of the same type. In order to investigate the effect of the cap on reducing the doses to the brain additional measurements were performed with a male Alderson Rando and polymethyl methacrylate (PMMA) phantoms representing the physician and the patient, respectively for different projections. The brain dose per procedure, annual and cumulated during entire working practice were estimated for both cases working with and without the cap. RESULTS The dose reduction factor (RF) for the skin (the quotient of doses outside and inside the cap) vary from 1.1 up to 4.0 in clinical conditions; on average 2.3-fold reduction is observed in the most exposed left temple. The RFs determined for the part of the head covered by the cap range from 1.4 to 1.8 while for the brain from 1.0 to 1.1 depending on the projection. The estimated annual brain dose for interventional cardiologist performing yearly 550 CA/PTCA procedures without any protective shields is 7.2 mGy and it is reduced with the lead free cap by an average factor of 1.1. CONCLUSIONS The study results proved the considerable effectiveness of lead free cap to protect the skin but very limited to protect the brain. Int J Occup Med Environ Health. 2022;35(5):549-60.
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Affiliation(s)
- Włodzimierz grabowicz
- Medical University of Lodz, Department of Interventional Cardiology and Cardiac Arrythmias, Łódź, Poland
| | - Konrad Masiarek
- Medical University of Lodz, Department of Interventional Cardiology and Cardiac Arrythmias, Łódź, Poland
| | - Tomasz Górnik
- Medical University of Lodz, Department of Interventional Cardiology and Cardiac Arrythmias, Łódź, Poland
| | - Tomasz Grycewicz
- Medical University of Lodz, Department of Interventional Cardiology and Cardiac Arrythmias, Łódź, Poland
| | - Marcin Brodecki
- Nofer Institute of Occupational Medicine, Department of Radiation Protection, Łódź, Poland
| | | | - Christelle Huet
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux Roses Cedex, France
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22
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Lopes J, Baudin C, Leuraud K, Klokov D, Bernier MO. Ionizing radiation exposure during adulthood and risk of developing central nervous system tumors: systematic review and meta-analysis. Sci Rep 2022; 12:16209. [PMID: 36171442 PMCID: PMC9519546 DOI: 10.1038/s41598-022-20462-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 09/13/2022] [Indexed: 11/24/2022] Open
Abstract
Many studies on ionizing radiation (IR) exposure during childhood have shown deleterious effects on the central nervous system (CNS), however results regarding adult exposure are inconsistent, and no systematic reviews have been performed. The objectives are to synthesize the findings and draw evidence-based conclusions from epidemiological studies on the risk of benign and malignant brain and CNS tumors in humans exposed to low-to-moderate doses (< 0.5 Gy) of IR during adulthood/young adulthood. A systematic literature search of four electronic databases, supplemented by a hand search, was performed to retrieve relevant epidemiological studies published from 2000 to 2022. Pooled excess relative risk (ERRpooled) was estimated using a random effect model. Eighteen publications were included in the systematic review and twelve out of them were included in a meta-analysis. The following IR sources were considered: atomic bombs, occupational, and environmental exposures. No significant dose-risk association was found for brain/CNS tumors (ERRpooled at 100 mGy = - 0.01; 95% CI: - 0.05, 0.04). Our systematic review and meta-analysis did not show any association between exposure to low-to-moderate doses of IR and risk of CNS tumors. Further studies with histological information and precise dose assessment are needed.
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Affiliation(s)
- Julie Lopes
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France.
| | - Clémence Baudin
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Klervi Leuraud
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Dmitry Klokov
- Laboratory of Radiobiology and Radiotoxicology (LRTOX) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
| | - Marie-Odile Bernier
- Laboratory of Epidemiology (LEPID) - Institute for Radiological Protection and Nuclear Safety (IRSN), 92262, Fontenay-aux-Roses, France
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23
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Imaoka T, Nishimura M, Daino K, Hosoki A, Kudo KI, Iizuka D, Nagata K, Takabatake M, Nishimura Y, Kokubo T, Morioka T, Doi K, Shimada Y, Kakinuma S. DOSE-RATE EFFECT OF RADIATION ON RAT MAMMARY CARCINOGENESIS AND AN EMERGING ROLE FOR STEM CELL BIOLOGY. RADIATION PROTECTION DOSIMETRY 2022; 198:1036-1046. [PMID: 36083756 DOI: 10.1093/rpd/ncac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/03/2022] [Accepted: 03/20/2021] [Indexed: 06/15/2023]
Abstract
The uncertain cancer risk of protracted radiation exposure at low dose rates is an important issue in radiological protection. Tissue stem/progenitor cells are a supposed origin of cancer and may contribute to the dose-rate effect on carcinogenesis. The authors have shown that female rats subjected to continuous whole body γ irradiation as juveniles or young adults have a notably reduced incidence of mammary cancer as compared with those irradiated acutely. Experiments using the mammosphere formation assay suggested the presence of radioresistant progenitor cells. Cell sorting indicated that basal progenitor cells in rat mammary gland were more resistant than luminal progenitors to killing by acute radiation, especially at high doses. Thus, the evidence indicates a cell-type-dependent inactivation of mammary cells that manifests only at high acute doses, implying a link to the observed dose-rate effect on carcinogenesis.
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Affiliation(s)
- Tatsuhiko Imaoka
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Mayumi Nishimura
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Kazuhiro Daino
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Ayaka Hosoki
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Ken-Ichi Kudo
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Department of Radiation Life Sciences, School of Medicine, Fukushima Medical University, Fukushima 960-1247, Japan
| | - Daisuke Iizuka
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Kento Nagata
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Masaru Takabatake
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo 116-8551, Japan
| | - Yukiko Nishimura
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Toshiaki Kokubo
- Laboratory Animal and Genome Sciences Section, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Takamitsu Morioka
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Kazutaka Doi
- Department of Radiation Regulatory Science Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
| | - Yoshiya Shimada
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
- Institute for Environmental Sciences, Aomori 039-3212, Japan
| | - Shizuko Kakinuma
- Department of Radiation Effects Research, National Institute of Radiological Sciences, National Institutes for Quantum Science and Technology, Chiba 263-8555, Japan
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24
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Onishi S, Yamasaki F, Amatya VJ, Takayasu T, Yonezawa U, Taguchi A, Ohba S, Takeshima Y, Horie N, Sugiyama K. Characteristics and therapeutic strategies of radiation-induced glioma: case series and comprehensive literature review. J Neurooncol 2022; 159:531-538. [PMID: 35922583 DOI: 10.1007/s11060-022-04090-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/05/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The so-called radiation-induced glioma (RIG, a secondary glioma after cranial irradiation), is a serious late effect after cranial radiation therapy. The clinical characteristics of and ideal treatment for these tumors are unclear. We analyzed our case series and conducted a comprehensive literature review to reveal the precise characteristics of RIGs. METHODS We analyzed the cases of six patients with RIGs treated at our institution and 354 patients with RIGs from the literature. The latency period from irradiation to the development of each RIG and the median overall survival of the patients were subjected to Kaplan-Meier analyses. Spearman's correlation test was used to determine the relationship between age at irradiation and the latency period. RESULTS The mean age of the 360 patients at the development of RIG was 27.42 ± 17.87 years. The mean latency period was 11.35 ± 8.58 years. Multiple gliomas were observed in 28.4%. WHO grade 3 and 4 RIGs accounted for 93.3%. The latency periods were significant shorter in the higher WHO grade group (p = 0.0366) and the concomitant systemic chemotherapy group (p < 0.0001). Age at irradiation was negatively associated with the latency period (r =- 0.2287, p = 0.0219). The patients treated with radiotherapy achieved significantly longer survival compared to those treated without radiotherapy (p = 0.0011). CONCLUSIONS Development in younger age, multiplicity, and high incidence of grade 3 and 4 are the clinical characteristics of RIGs. Cranial irradiation at older ages and concomitant chemotherapy were associated with shorter latency for the development of RIG. Radiation therapy may be the feasible treatment option despite radiation-induced gliomas.
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Affiliation(s)
- Shumpei Onishi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan.
- Department of Neurosurgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan.
| | - Fumiyuki Yamasaki
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Vishwa Jeet Amatya
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Takeshi Takayasu
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Ushio Yonezawa
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Akira Taguchi
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Shinji Ohba
- Department of Neurosurgery, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, 3-1 Aoyama-cho, Kure City, Hiroshima, 737-0023, Japan
| | - Yukio Takeshima
- Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Nobutaka Horie
- Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-oncology Program, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City, Hiroshima, 734-8551, Japan
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25
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Secondary cancer after meningioma diagnosis: an Israeli national study. Cancer Causes Control 2022; 33:1277-1284. [DOI: 10.1007/s10552-022-01609-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/29/2022] [Indexed: 10/16/2022]
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26
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Auvinen A, Cardis E, Blettner M, Moissonnier M, Sadetzki S, Giles G, Johansen C, Swerdlow A, Cook A, Fleming S, Berg-Beckhoff G, Iavarone I, Parent ME, Woodward A, Tynes T, McBride M, Krewski D, Feychting M, Takebayashi T, Armstrong B, Hours M, Siemiatycki J, Lagorio S, Larsen SB, Schoemaker M, Klaeboe L, Lönn S, Schüz J. Diagnostic radiological examinations and risk of intracranial tumours in adults-findings from the Interphone Study. Int J Epidemiol 2022; 51:537-546. [PMID: 34648614 PMCID: PMC9082802 DOI: 10.1093/ije/dyab140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Exposure to high doses of ionizing radiation is among the few well-established brain tumour risk factors. We used data from the Interphone study to evaluate the effects of exposure to low-dose radiation from diagnostic radiological examinations on glioma, meningioma and acoustic neuroma risk. METHODS Brain tumour cases (2644 gliomas, 2236 meningiomas, 1083 neuromas) diagnosed in 2000-02 were identified through hospitals in 13 countries, and 6068 controls (population-based controls in most centres) were included in the analysis. Participation across all centres was 64% for glioma cases, 78% for meningioma cases, 82% for acoustic neuroma cases and 53% for controls. Information on previous diagnostic radiological examinations was obtained by interviews, including the frequency, timing and indication for the examinations. Typical brain doses per type of examination were estimated based on the literature. Examinations within the 5 years before the index date were excluded from the dose estimation. Adjusted odds ratios were estimated using conditional logistic regression. RESULTS No materially or consistently increased odds ratios for glioma, meningioma or acoustic neuroma were found for any specific type of examination, including computed tomography of the head and cerebral angiography. The only indication of an elevated risk was an increasing trend in risk of meningioma with the number of isotope scans, but no such trends for other examinations were observed. No gradient was found in risk with estimated brain dose. Age at exposure did not substantially modify the findings. Sensitivity analyses gave results consistent with the main analysis. CONCLUSIONS There was no consistent evidence for increased risks of brain tumours with X-ray examinations, although error from selection and recall bias cannot be completely excluded. A cautious interpretation is warranted for the observed association between isotope scans and meningioma.
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Affiliation(s)
- Anssi Auvinen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere
University, Tampere, Finland
- STUK—Radiation and Nuclear Safety Authority, Helsinki,
Finland
| | - Elisabeth Cardis
- Barcelona Institute of Global Health (ISGlobal), Centre for Research in
Environmental Epidemiology, Universitat Pompeu Funebra, Barcelona,
Spain
- CIBER Epidemiologia y Salud Publica, Madrid, Spain
| | | | | | | | - Graham Giles
- Cancer Council Victoria, Melbourne, VIC, Australia
| | | | - Anthony Swerdlow
- Division of Genetics and Epidemiology, Institute of Cancer
Research, London, UK
- Division of Breast Cancer Research, Institute of Cancer
Research, London, UK
| | - Angus Cook
- School of Population and Global Health, University of Western
Australia, Crawley, WA, Australia
| | | | | | | | - Marie-Elise Parent
- INRS Centre Armand-Frappier Santé Biotechnologie, Institut National de la
Recherche Scientifique, Université du Québec, Laval, QC, Canada
| | - Alistair Woodward
- School of Population Health, University of Auckland,
Auckland, New Zealand
| | - Tore Tynes
- National Institute of Occupational Health, Oslo, Norway
| | - Mary McBride
- British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Dan Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of
Ottawa, ON, Canada
| | | | | | - Bruce Armstrong
- School of Public Health, University of Sydney, Sydney, NSW,
Australia
| | | | | | | | | | - Minouk Schoemaker
- Division of Genetics and Epidemiology, Institute of Cancer
Research, London, UK
| | - Lars Klaeboe
- Norwegian Radiation Protection Authority, Østerås, Norway
| | - Stefan Lönn
- Karolinska Institutet, Stockholm, Sweden
- Region Halland, Research and Development, Sweden
| | - Joachim Schüz
- International Agency for Research on Cancer, Lyon, France
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Brenner AV, Preston DL, Sakata R, Cologne J, Sugiyama H, Utada M, Cahoon EK, Grant E, Mabuchi K, Ozasa K. Comparison of All Solid Cancer Mortality and Incidence Dose-Response in the Life Span Study of Atomic Bomb Survivors, 1958-2009. Radiat Res 2022; 197:491-508. [PMID: 35213725 PMCID: PMC10273292 DOI: 10.1667/rade-21-00059.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 01/10/2022] [Indexed: 11/03/2022]
Abstract
Recent analysis of all solid cancer incidence (1958-2009) in the Life Span Study (LSS) revealed evidence of upward curvature in the radiation dose response among males but not females. Upward curvature in sex-averaged excess relative risk (ERR) for all solid cancer mortality (1950-2003) was also observed in the 0-2 Gy dose range. As reasons for non-linearity in the LSS are not completely understood, we conducted dose-response analyses for all solid cancer mortality and incidence applying similar methods [1958-2009 follow-up, DS02R1 doses, including subjects not-in-city (NIC) at the time of the bombing] and statistical models. Incident cancers were ascertained from Hiroshima and Nagasaki cancer registries, while cause of death was ascertained from death certificates throughout Japan. The study included 105,444 LSS subjects who were alive and not known to have cancer before January 1, 1958 (80,205 with dose estimates and 25,239 NIC subjects). Between 1958 and 2009, there were 3.1 million person-years (PY) and 22,538 solid cancers for incidence analysis and 3.8 million PY and 15,419 solid cancer deaths for mortality analysis. We fitted sex-specific ERR models adjusted for smoking to both types of data. Over the entire range of doses, solid cancer mortality dose-response exhibited a borderline significant upward curvature among males (P = 0.062) and significant upward curvature among females (P = 0.010); for solid cancer incidence, as before, we found a significant upward curvature among males (P = 0.001) but not among females (P = 0.624). The sex difference in magnitude of dose-response curvature was statistically significant for cancer incidence (P = 0.017) but not for cancer mortality (P = 0.781). The results of analyses in the 0-2 Gy range and restricted lower dose ranges generally supported inferences made about the sex-specific dose-response shape over the entire range of doses for each outcome. Patterns of sex-specific curvature by calendar period (1958-1987 vs. 1988-2009) and age at exposure (0-19 vs. 20-83) varied between mortality and incidence data, particularly among females, although for each outcome there was an indication of curvature among 0-19-year-old male survivors in both calendar periods and among 0-19-year-old female survivors in the recent period. Collectively, our findings indicate that the upward curvature in all solid cancer dose response in the LSS is neither specific to males nor to incidence data; its evidence appears to depend on the composition of sites comprising all solid cancer group and age at exposure or time. Further follow up and site-specific analyses of cancer mortality and incidence will be important to confirm the emerging trend in dose-response curvature among young survivors and unveil the contributing factors and sites.
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Affiliation(s)
- AV Brenner
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - DL Preston
- Hirosoft International Corporation, Eureka, California
| | - R Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - J Cologne
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - H Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - M Utada
- Hirosoft International Corporation, Eureka, California
| | - EK Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - E Grant
- Associated Chief of Research, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - K Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - K Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
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Abstract
ABSTRACT The human brain dose from radon-222 (222Rn) exposure is calculated here using 222Rn tissue solubility data. A fraction of 222Rn inhaled dissolves in blood and cellular fluids and circulates to brain and all organs. Radon-222 has a relatively high solubility in blood and body fluids based on human inhalation experiments. The brain dose uses calculated concentrations of 222Rn in blood and cellular fluids from exhaled breath measurements following human exposure in a 222Rn chamber. The annual brain dose from continuous inhalation of a concentration of 100 Bq m-3 is about 450 times less than the dose to bronchial epithelium from inhalation of the same 222Rn concentration. Based on the 222Rn dosimetry here, it is highly unlikely that brain cancer is related to even high 222Rn exposures. Any functional or neurodegenerative issues from exposure to very small doses of 222Rn alpha particles are, at present, unknown.
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Affiliation(s)
- Naomi H Harley
- Naomi H. Harley, New York University School of Medicine, Department of Environmental Medicine, Marine View Plaza, Apt. 24E, Hoboken, NJ 07030
| | - Edith S Robbins
- Edith S. Robbins, New York University School of Medicine, Department of Cell Biology, (retired)
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29
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Race and ethnic group dependent space radiation cancer risk predictions. Sci Rep 2022; 12:2028. [PMID: 35132138 PMCID: PMC8821552 DOI: 10.1038/s41598-022-06105-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 01/18/2022] [Indexed: 12/22/2022] Open
Abstract
Future space missions by national space agencies and private industry, including space tourism, will include a diverse makeup of crewmembers with extensive variability in age, sex, and race or ethnic groups. The relative risk (RR) model is used to transfer epidemiology data between populations to estimate radiation risks. In the RR model cancer risk is assumed to be proportional to background cancer rates and limited by other causes of death, which are dependent on genetic, environmental and dietary factors that are population dependent. Here we apply the NSCR-2020 model to make the first predictions of age dependent space radiation cancer risks for several U.S. populations, which includes Asian-Pacific Islanders (API), Black, Hispanic (white and black), and White (non-Hispanic) populations. Results suggest that male API and Hispanic populations have the overall lowest cancer risks, while White females have the highest risk. Blacks have similar total cancer rates than Whites, however their reduced life expectancy leads to modestly lower lifetime radiation risks compared to Whites. There are diverse tissue specific cancer risk ranking across sex and race, which include sex specific organ risks, female’s having larger lung, stomach, and urinary-bladder radiation risks, and male’s having larger colon and brain risks.
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30
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Rühm W, Laurier D, Wakeford R. Cancer risk following low doses of ionising radiation - Current epidemiological evidence and implications for radiological protection. MUTATION RESEARCH. GENETIC TOXICOLOGY AND ENVIRONMENTAL MUTAGENESIS 2022; 873:503436. [PMID: 35094811 DOI: 10.1016/j.mrgentox.2021.503436] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/09/2021] [Accepted: 12/11/2021] [Indexed: 01/05/2023]
Abstract
Recent studies suggest that every year worldwide about a million patients might be exposed to doses of the order of 100 mGy of low-LET radiation, due to recurrent application of radioimaging procedures. This paper presents a synthesis of recent epidemiological evidence on radiation-related cancer risks from low-LET radiation doses of this magnitude. Evidence from pooled analyses and meta-analyses also involving epidemiological studies that, individually, do not find statistically significant radiation-related cancer risks is reviewed, and evidence from additional and more recent epidemiological studies of radiation exposures indicating excess cancer risks is also summarized. Cohorts discussed in the present paper include Japanese atomic bomb survivors, nuclear workers, patients exposed for medical purposes, and populations exposed environmentally to natural background radiation or radioactive contamination. Taken together, the overall evidence summarized here is based on studies including several million individuals, many of them followed-up for more than half a century. In summary, substantial evidence was found from epidemiological studies of exposed groups of humans that ionizing radiation causes cancer at acute and protracted doses above 100 mGy, and growing evidence for doses below 100 mGy. The significant radiation-related solid cancer risks observed at doses of several 100 mGy of protracted exposures (observed, for example, among nuclear workers) demonstrate that doses accumulated over many years at low dose rates do cause stochastic health effects. On this basis, it can be concluded that doses of the order of 100 mGy from recurrent application of medical imaging procedures involving ionizing radiation are of concern, from the viewpoint of radiological protection.
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Affiliation(s)
- W Rühm
- Helmholtz Center Munich German Research Center for Environmental Health, Neuherberg, Germany.
| | - D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - R Wakeford
- Centre for Occupational and Environmental Health, The University of Manchester, Manchester, M13 9PL, UK
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31
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Goldbrunner R, Stavrinou P, Jenkinson MD, Sahm F, Mawrin C, Weber DC, Preusser M, Minniti G, Lund-Johansen M, Lefranc F, Houdart E, Sallabanda K, Le Rhun E, Nieuwenhuizen D, Tabatabai G, Soffietti R, Weller M. EANO guideline on the diagnosis and management of meningiomas. Neuro Oncol 2021; 23:1821-1834. [PMID: 34181733 PMCID: PMC8563316 DOI: 10.1093/neuonc/noab150] [Citation(s) in RCA: 280] [Impact Index Per Article: 93.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Meningiomas are the most common intracranial tumors. Yet, only few controlled clinical trials have been conducted to guide clinical decision making, resulting in variations of management approaches across countries and centers. However, recent advances in molecular genetics and clinical trial results help to refine the diagnostic and therapeutic approach to meningioma. Accordingly, the European Association of Neuro-Oncology (EANO) updated its recommendations for the diagnosis and treatment of meningiomas. A provisional diagnosis of meningioma is typically made by neuroimaging, mostly magnetic resonance imaging. Such provisional diagnoses may be made incidentally. Accordingly, a significant proportion of meningiomas, notably in patients that are asymptomatic or elderly or both, may be managed by a watch-and-scan strategy. A surgical intervention with tissue, commonly with the goal of gross total resection, is required for the definitive diagnosis according to the WHO classification. A role for molecular profiling including gene panel sequencing and genomic methylation profiling is emerging. A gross total surgical resection including the involved dura is often curative. Inoperable or recurrent tumors requiring treatment can be treated with radiosurgery, if the size or the vicinity of critical structures allows that, or with fractionated radiotherapy (RT). Treatment concepts combining surgery and radiosurgery or fractionated RT are increasingly used, although there remain controversies regard timing, type, and dosing of the various RT approaches. Radionuclide therapy targeting somatostatin receptors is an experimental approach, as are all approaches of systemic pharmacotherapy. The best albeit modest results with pharmacotherapy have been obtained with bevacizumab or multikinase inhibitors targeting vascular endothelial growth factor receptor, but no standard of care systemic treatment has been yet defined.
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Affiliation(s)
- Roland Goldbrunner
- Center of Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Pantelis Stavrinou
- Neurosurgical Department, Metropolitan Hospital, Athens, Greece and Center of Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Michael D Jenkinson
- Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Felix Sahm
- Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Mawrin
- Department of Neuropathology, University of Magdeburg, Magdeburg, Germany
| | - Damien C Weber
- Center for Proton Therapy, Paul Scherrer Institute, Villigen, Switzerland
| | - Matthias Preusser
- Department of Medicine I, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria
| | - Giuseppe Minniti
- Radiation Oncology Unit, Sant’Andrea Hospital, Sapienza University, Rome, Italy
| | - Morten Lund-Johansen
- Department of Neurosurgery, Bergen University Hospital, Bergen, Norway
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Florence Lefranc
- Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Emanuel Houdart
- Service de Neuroradiologie, Hopital Lariboisiere, Paris, France
| | - Kita Sallabanda
- Department of Neurosurgery, University Hospital San Carlos, Universidad Complutense de Madrid, Madrid, Spain
- Hospital Clinico Universitario San Carlos, Madrid, Spain
- CyberKnife Centre, Genesiscare Madrid, Madrid, Spain
| | - Emilie Le Rhun
- Department of Neurology and Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Ghazaleh Tabatabai
- Center for Neurooncology, Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Riccardo Soffietti
- Department of Neuro-Oncology, City of Health and Science University Hospital, Turin, Italy
| | - Michael Weller
- Department of Neurology, Clinical Neuroscience Center, University Hospital and University of Zurich, Zurich, Switzerland
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32
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Laurier D, Rühm W, Paquet F, Applegate K, Cool D, Clement C. Areas of research to support the system of radiological protection. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2021; 60:519-530. [PMID: 34657188 PMCID: PMC8522113 DOI: 10.1007/s00411-021-00947-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/05/2021] [Indexed: 05/07/2023]
Abstract
This document presents the ICRP's updated vision on "Areas of Research to Support the System of Radiological Protection", which have been previously published in 2017. It aims to complement the research priorities promoted by other relevant international organisations, with the specificity of placing them in the perspective of the evolution of the System of Radiological Protection. This document contributes to the process launched by ICRP to review and revise the System of Radiological Protection that will update the 2007 General Recommendations in ICRP Publication 103.
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Affiliation(s)
- D Laurier
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Fontenay-aux-Roses, France
| | - W Rühm
- Helmholtz Center Munich, German Research Center for Environmental Health, Neuherberg, Germany.
| | - F Paquet
- Institut de Radioprotection et de Sûreté Nucléaire (IRSN), Cadarache, France
| | - K Applegate
- University of Kentucky College of Medicine, Lexington, KY, USA
| | - D Cool
- International Commission on Radiological Protection (ICRP) Vice-Chair, Charlotte, NC, USA
| | - C Clement
- International Commission on Radiological Protection (ICRP), Ottawa, ON, Canada
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33
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Mitochondrial DNA sequence variation and risk of meningioma. J Neurooncol 2021; 155:319-324. [PMID: 34669147 DOI: 10.1007/s11060-021-03878-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 10/13/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Risk factors for meningioma include female gender, African American race, high body mass index (BMI), and exposure to ionizing radiation. Although genome-wide association studies (GWAS) have identified two nuclear genome risk loci for meningioma (rs12770228 and rs2686876), the relation between mitochondrial DNA (mtDNA) sequence variants and meningioma is unknown. METHODS We examined the association of 42 common germline mtDNA variants (minor allele frequency ≥ 5%), haplogroups, and genes with meningioma in 1080 controls and 478 meningioma cases from a case-control study conducted at medical centers in the southeastern United States. Associations were examined separately for meningioma overall and by WHO grade (n = 409 grade I and n = 69 grade II/III). RESULTS Overall, meningioma was significantly associated with being female (OR 2.85; 95% CI 2.21-3.69), self-reported African American race (OR 2.38, 95% CI 1.41-3.99), and being overweight (OR 1.48; 95% CI 1.11-1.97) or obese (OR 1.70; 95% CI 1.25-2.31). The variant m.16362T > C (rs62581341) in the mitochondrial control region was positively associated with grade II/III meningiomas (OR 2.33; 95% CI 1.14-4.77), but not grade I tumors (OR 0.99; 95% CI 0.64-1.53). Haplogroup L, a marker for African ancestry, was associated with meningioma overall (OR 2.92; 95% CI 1.01-8.44). However, after stratifying by self-reported race, this association was only apparent among the few self-reported Caucasians with this haplogroup (OR 6.35; 95% CI 1.56-25.9). No other mtDNA variant, haplogroup, or gene was associated with meningioma. CONCLUSION Common mtDNA variants and major mtDNA haplogroups do not appear to have associations with the odds of developing meningioma.
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Boice JD, Cohen SS, Mumma MT, Golden AP, Howard SC, Girardi DJ, Ellis ED, Bellamy MB, Dauer LT, Samuels C, Eckerman KF, Leggett RW. Mortality among workers at the Los Alamos National Laboratory, 1943-2017. Int J Radiat Biol 2021; 98:722-749. [PMID: 34047625 DOI: 10.1080/09553002.2021.1917784] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND During World War II (WWII), the Manhattan Engineering District established a secret laboratory in the mountains of northern New Mexico. The mission was to design, construct and test the first atomic weapon, nicknamed 'The Gadget' that was detonated at the TRINITY site in Alamogordo, NM. After WWII, nuclear weapons research continued, and the laboratory became the Los Alamos National Laboratory (LANL). MATERIALS AND METHODS The mortality experience of 26,328 workers first employed between 1943 and 1980 at LANL was determined through 2017. Included were 6157 contract workers employed by the ZIA Company. Organ dose estimates for each worker considered all sources of exposure, notably photons, neutrons, tritium, 238Pu and 239Pu. Vital status determination included searches within the National Death Index, Social Security Administration and New Mexico State Mortality Files. Standardized Mortality Ratios (SMR) and Cox regression models were used in the analyses. RESULTS Most workers (55%) were hired before 1960, 38% had a college degree, 25% were female, 81% white, 13% Hispanic and 60% had died. Vital status was complete, with only 0.1% lost to follow-up. The mean dose to the lung for the 17,053 workers monitored for radiation was 28.6 weighted-mGy (maximum 16.8 weighted-Gy) assuming a Dose Weighting Factor of 20 for alpha particle dose to lung. The Excess Relative Risk (ERR) at 100 weighted-mGy was 0.01 (95%CI -0.02, 0.03; n = 839) for lung cancer. The ERR at 100 mGy was -0.43 (95%CI -1.11, 0.24; n = 160) for leukemia other than chronic lymphocytic leukemia (CLL), -0.06 (95%CI -0.16, 0.04; n = 3043) for ischemic heart disease (IHD), and 0.29 (95%CI 0.02, 0.55; n = 106) for esophageal cancer. Among the 6499 workers with measurable intakes of plutonium, an increase in bone cancer (SMR 2.44; 95%CI 0.98, 5.03; n = 7) was related to dose. The SMR for berylliosis was significantly high, based on 4 deaths. SMRs for Hispanic workers were significantly high for cancers of the stomach and liver, cirrhosis of the liver, nonmalignant kidney disease and diabetes, but the excesses were not related to radiation dose. CONCLUSIONS There was little evidence that radiation increased the risk of lung cancer or leukemia. Esophageal cancer was associated with radiation, and plutonium intakes were linked to an increase of bone cancer. IHD was not associated with radiation dose. More precise evaluations will await the pooled analysis of workers with similar exposures such as at Rocky Flats, Savannah River and Hanford.
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Affiliation(s)
- John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | | | - Michael T Mumma
- International Epidemiology Institute, Rockville, MD, USA.,International Epidemiology Field Station, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Ashley P Golden
- ORISE Health Studies Program, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - Sara C Howard
- ORISE Health Studies Program, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | - David J Girardi
- ORISE Health Studies Program, Oak Ridge Associated Universities, Oak Ridge, TN, USA
| | | | - Michael B Bellamy
- Department of Medical Physics and Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lawrence T Dauer
- Department of Medical Physics and Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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35
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Kadowaki Y, Hamada N, Kai M, Furukawa K. Evaluation of the lifetime brain/central nervous system cancer risk associated with childhood head CT scanning in Japan. Int J Cancer 2021; 148:2429-2439. [PMID: 33320957 DOI: 10.1002/ijc.33436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/17/2020] [Accepted: 12/01/2020] [Indexed: 11/07/2022]
Abstract
The use of computed tomography (CT) scanning has increased worldwide over the decades, and Japan is one of the leading countries in annual frequency of diagnostic CT. Although benefits of CT scan are undisputable, concerns have been raised about potential health effects of ionizing radiation exposure from CT, particularly among children who are likely more susceptible to radiation than adults. Our study aims to evaluate the cumulated lifetime risk of the brain/central nervous system (CNS) cancer due to head CT examinations performed on Japanese children at age 0 to 10 years in 2012, 2015 and 2018. The frequency and dose distribution of head CT examinations were estimated based on information from recent national statistics and nationwide surveys. The lifetime risk attributable to exposure was calculated by applying risk models based on the study of Japanese atomic-bomb survivors. In contrast to the overall increasing trend, the frequency of childhood CT, especially at age < 5, was decreasing, reflecting a growing awareness for efforts to reduce childhood CT exposure over the past decade. In 2018, 138 532 head CT examinations were performed at age 0 to 10, which would consequently induce a lifetime excess of 22 cases (1 per 6300 scans) of brain/CNS cancers, accounting for 5% of the total cases. More excess cases were estimated among men than among women, and excess cases could emerge at relatively young ages. These results would have useful implications as scientific basis for future large-scale epidemiological studies and also as quantitative evidence to justify the benefits of CT vs risks in Japan.
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Affiliation(s)
- Yuko Kadowaki
- Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), Tokyo, Japan
| | - Michiaki Kai
- Department of Environmental Health Science, Oita University of Nursing and Health Sciences, Oita, Japan
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36
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Grant EJ, Yamamura M, Brenner AV, Preston DL, Utada M, Sugiyama H, Sakata R, Mabuchi K, Ozasa K. Radiation Risks for the Incidence of Kidney, Bladder and Other Urinary Tract Cancers: 1958-2009. Radiat Res 2021; 195:140-148. [PMID: 33264396 DOI: 10.1667/rade-20-00158.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/12/2020] [Indexed: 11/03/2022]
Abstract
As part of the recent series of articles to create a comprehensive description of the radiation risks of solid cancer incidence after ionizing radiation exposure, based on the atomic bomb survivors' Life Span Study (LSS), this work focuses on the risks of urinary tract cancer (UTC) and kidney cancer. Analyses covered a 52-year period of follow-up, through 2009, among 105,444 eligible survivors who were alive and cancer free in 1958. This represents an additional 11 years of follow-up since the last comprehensive report, with a total of 3,079,502 person-years. We observed 790 UTC and 218 kidney cancer cases. Adjusted for smoking, there was a strong linear radiation dose response for UTC. The sex-averaged excess relative risk per 1 Gy (ERR/Gy) was 1.4 (95% confidence interval, CI: 0.82 to 2.1). Both males and females showed significantly increased ERRs/Gy with female point estimates at a factor of 3.4 (95% CI: 1.4 to 8.6) greater than male estimates. UTC radiation risks were largely unmodified by age at exposure or attained age. The attributable fraction of UTC to radiation exposure was approximately 18% while that attributed to smoking was 48%. Kidney cancer showed an increased ERR due to smoking (0.56 per 50 pack-years; 95% CI -0.007 to 1.6; P = 0.054), but we did not observe any strong associations of kidney cancer with radiation exposure, although sex-specific dose responses were found to be statistically different.
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Affiliation(s)
- Eric J Grant
- Associate Chief of Research, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Mariko Yamamura
- Department of Statistics, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Alina V Brenner
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | | | - Mai Utada
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Hiromi Sugiyama
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Ritsu Sakata
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
| | - Kiyohiko Mabuchi
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland
| | - Kotaro Ozasa
- Department of Epidemiology, Radiation Effects Research Foundation, Hiroshima and Nagasaki, Japan
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37
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Journy NMY, Zrafi WS, Bolle S, Fresneau B, Alapetite C, Allodji RS, Berchery D, Haddy N, Kobayashi I, Labbé M, Pacquement H, Pluchart C, Schwartz B, Souchard V, Thomas-Teinturier C, Veres C, Vu-Bezin G, Diallo I, de Vathaire F. Risk Factors of Subsequent Central Nervous System Tumors after Childhood and Adolescent Cancers: Findings from the French Childhood Cancer Survivor Study. Cancer Epidemiol Biomarkers Prev 2020; 30:133-141. [PMID: 33033142 DOI: 10.1158/1055-9965.epi-20-0735] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/31/2020] [Accepted: 09/30/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Childhood or adolescent cancer survivors are at increased risks of subsequent primary neoplasms (SPN) of the central nervous system (CNS) after cranial irradiation. In a large multicentric cohort, we investigated clinical and therapeutic factors associated with the long-term risk of CNS SPN, and quantified the dose-response relationships. METHODS We selected all CNS SPN cases diagnosed up to 2016 among members of the French Childhood Cancer Survivor Study at least 5 years after first cancer diagnosis in 1946-2000. Four controls per case were randomly selected within the cohort and matched by sex, year of/age at first cancer diagnosis, and follow-up time. On the basis of medical and radiological reports, cumulative radiation doses received to the SPN or matched location were retrospectively estimated using mathematical phantoms. We computed conditional logistic regression models. RESULTS Meningioma risk significantly increased with higher radiation doses [excess OR per Gy (EOR/Gy) = 1.377; P < 0.001; 86 cases; median latency time = 30 years], after adjustment for reported genetic syndromes and first CNS tumor. It was higher among youngest individuals at first cancer diagnosis, but did not vary with follow-up time. On the opposite, radiation-related glioma risk (EOR/Gy = 0.049; P = 0.11; 47 cases; median latency time = 17 years) decreased over time (P for time effect = 0.05). There was a significant association between meningioma risk and cumulative doses of alkylating agents, but no association with growth hormone therapy. CONCLUSIONS The surveillance of patients with cranial irradiation should continue beyond 30 years after treatment. IMPACT The identified risk factors may inform long-term surveillance strategies.
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Affiliation(s)
- Neige Marie Yvanne Journy
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France. .,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Wael Salem Zrafi
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France.,Department of Radiation Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Stéphanie Bolle
- Department of Radiation Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Brice Fresneau
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France.,Department of Children and Adolescent Oncology, Gustave Roussy, Villejuif, Paris, France
| | - Claire Alapetite
- Department of Radiation Oncology, Institut Curie, Paris, France.,Institut Curie, Proton Therapy Center, Orsay, Paris, France
| | - Rodrigue Setcheou Allodji
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Delphine Berchery
- Department of Medical Information, Institut Claudius Régaud, Toulouse, France
| | - Nadia Haddy
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Isao Kobayashi
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Martine Labbé
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Hélène Pacquement
- Department of Pediatric Medical Oncology, Institut Curie, Paris, France
| | - Claire Pluchart
- Department of Pediatric Hematology-Oncology, Institut Jean Godinot, Reims, France
| | - Boris Schwartz
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Vincent Souchard
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Cécile Thomas-Teinturier
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France.,Department of Paediatric Endocrinology, APHP, Paris-Sud Hospital, site Bicêtre, Le Kremlin Bicêtre, France
| | - Cristina Veres
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France.,Inserm UMR 1030, Gustave Roussy Cancer Campus, Villejuif, Paris, France
| | - Giao Vu-Bezin
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Ibrahima Diallo
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
| | - Florent de Vathaire
- Inserm U1018, CESP, Radiation Epidemiology Team, Gustave Roussy, Villejuif, Paris, France.,Paris-Saclay, Paris-Sud University, Villejuif, Paris, France
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Narro-Donate JM, Velasco-Albendea FJ, García-Pérez F, Gomar-Alba M, Castelló-Ruiz MJ, Masegosa-González J. Different radioinducid tumors synchrony in an acute lymphoblastic leukemia survivor. Neurocirugia (Astur) 2020; 32:S1130-1473(20)30101-9. [PMID: 33012645 DOI: 10.1016/j.neucir.2020.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 07/22/2020] [Accepted: 07/25/2020] [Indexed: 11/21/2022]
Abstract
The cranial radiation-induced tumors appearance in pediatric patients treated for hematological diseases such as leukemia/T-lymphoblastic lymphoma (T-ALL/LBL) is a known phenomenon that may include lesions of different malignant degrees and require neurosurgical treatment. We present the case of a 38-year-old man referred to our department for a sudden diplopia with 6-month progressive left hemiparesis and frequent falls. After imaging tests, different intra and extraxial lesions with different radiological behavior were observed, performing a single surgical approach for their resection. The pathological anatomy confirms four histological variants: meningioma (grade 1 and 2 [atypical]), subependymoma, and cavernoma. We discuss the teratogenic role of ionizing radiation.
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Affiliation(s)
| | | | | | - Mario Gomar-Alba
- Departamento de Neurocirugía, Complejo Hospitalario Torrecárdenas, Almería, España
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39
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Boice JD, Cohen SS, Mumma MT, Chen H, Golden AP, Beck HL, Till JE. Mortality among U.S. military participants at eight aboveground nuclear weapons test series. Int J Radiat Biol 2020; 98:679-700. [PMID: 32602389 DOI: 10.1080/09553002.2020.1787543] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Approximately 235,000 military personnel participated at one of 230 U.S. atmospheric nuclear weapons tests from 1945 through 1962. At the Nevada Test Site (NTS), the atomic veterans participated in military maneuvers, observed nuclear weapons tests, or provided technical support. At the Pacific Proving Ground (PPG), they served aboard ships or were stationed on islands during or after nuclear weapons tests. MATERIAL AND METHODS Participants at seven test series, previously studied with high-quality dosimetry and personnel records, and the first test at TRINITY formed the cohort of 114,270 male military participants traced for vital status from 1945 through 2010. Dose reconstructions were based on Nuclear Test Personnel Review records, Department of Defense. Standardized mortality ratios (SMR) and Cox and Poisson regression models were used in the analysis. RESULTS Most atomic veterans were enlisted men, served in the Navy at the PPG, and were born before 1930. Vital status was determined for 96.8% of the veterans; 60% had died. Enlisted men had significantly high all-causes mortality SMR (1.06); officers had significantly low all-causes mortality SMR (0.71). The pattern of risk over time showed a diminution of the 'healthy soldier effect': the all-causes mortality SMR after 50 years of follow-up was 1.00. The healthy soldier effect for all cancers also diminished over time. The all-cancer SMR was significantly high after 50 years (SMR 1.10) primarily from smoking-related cancers, attributed in part to the availability of cigarettes in military rations. The highest SMR was for mesothelioma (SMR 1.56) which was correlated with asbestos exposure in naval ships. Prostate cancer was significantly high (SMR 1.13). Ischemic heart disease was significantly low (SMR 0.84). Estimated mean doses varied by organ were low; e.g., the mean red bone marrow dose was 6 mGy (maximum 108 mGy). Internal cohort dose-response analyses provided no evidence for increasing trends with radiation dose for leukemia (excluding chronic lymphocytic leukemia (CLL)) [ERR (95% CI) per 100 mGy -0.37 (-1.08, 0.33); n = 710], CLL, myelodysplastic syndrome, multiple myeloma, ischemic heart disease, or cancers of the lung, prostate, breast, and brain. CONCLUSION No statistically significant radiation associations were observed among 114,270 nuclear weapons test participants followed for up to 65 years. The 95% confidence limits were narrow and excluded mortality risks per unit dose that are two to four times higher than those reported in other investigations. Significantly elevated SMRs were seen for mesothelioma and asbestosis, attributed to asbestos exposure aboard ships.
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Affiliation(s)
- John D Boice
- National Council on Radiation Protection and Measurements, Bethesda, MD, USA.,Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center and Vanderbilt-Ingram Cancer Center, Nashville, TN, USA
| | - Sarah S Cohen
- EpidStrategies, a Division of ToxStrategies, Cary, NC, USA
| | | | - Heidi Chen
- Vanderbilt-Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA
| | | | | | - John E Till
- Risk Assessment Corporation, Neeses, SC, USA
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