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A Pooled Analysis of Thyroid Cancer Incidence Following Radiotherapy for Childhood Cancer

Veiga, Lene H. S.; Lubin, Jay H.; Anderson, Harald LU ; de Vathaire, Florent; Tucker, Margaret; Bhatti, Parveen; Schneider, Arthur; Johansson, Robert; Inskip, Peter and Kleinerman, Ruth, et al. (2012) In Radiation Research 178(4). p.365-376
Abstract
Childhood cancer five-year survival now exceeds 70-80%. Childhood exposure to radiation is a known thyroid carcinogen; however, data are limited for the evaluation of radiation dose-response at high doses, modifiers of the dose-response relationship and joint effects of radiotherapy and chemotherapy. To address these issues, we pooled two cohort and two nested case-control studies of childhood cancer survivors including 16,757 patients, with 187 developing primary thyroid cancer. Relative risks (RR) with 95% confidence intervals (CI) for thyroid cancer by treatment with alkylating agents, anthracyclines or bleomycin were 3.25 (0.9-14.9), 4.5 (1.4-17.8) and 3.2 (0.8-10.4), respectively, in patients without radiotherapy, and declined with... (More)
Childhood cancer five-year survival now exceeds 70-80%. Childhood exposure to radiation is a known thyroid carcinogen; however, data are limited for the evaluation of radiation dose-response at high doses, modifiers of the dose-response relationship and joint effects of radiotherapy and chemotherapy. To address these issues, we pooled two cohort and two nested case-control studies of childhood cancer survivors including 16,757 patients, with 187 developing primary thyroid cancer. Relative risks (RR) with 95% confidence intervals (CI) for thyroid cancer by treatment with alkylating agents, anthracyclines or bleomycin were 3.25 (0.9-14.9), 4.5 (1.4-17.8) and 3.2 (0.8-10.4), respectively, in patients without radiotherapy, and declined with greater radiation dose (RR trends, P = 0.02, 0.12 and 0.01, respectively). Radiation dose-related RRs increased approximately linearly for <10 Gy, leveled off at 10-15-fold for 10-30 Gy and then declined, but remained elevated for doses >50 Gy. The fitted RR at 10 Gy was 13.7 (95% CI: 8.0-24.0). Dose-related excess RRs increased with decreasing age at exposure (P < 0.01), but did not vary with attained age or time-since-exposure, remaining elevated 25+ years after exposure. Gender and number of treatments did not modify radiation effects. Thyroid cancer risks remained elevated many decades following radiotherapy, highlighting the need for continued follow up of childhood cancer survivors. (C) 2012 by Radiation Research Society (Less)
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Radiation Research
volume
178
issue
4
pages
365 - 376
publisher
Radiation Research Society
external identifiers
  • wos:000309791000013
  • scopus:84867080213
ISSN
0033-7587
DOI
10.1667/RR2889.1
language
English
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yes
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f25b8595-829f-4d64-8aef-f0a139a240e5 (old id 3175107)
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2012-12-03 06:54:17
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2017-08-20 04:07:08
@article{f25b8595-829f-4d64-8aef-f0a139a240e5,
  abstract     = {Childhood cancer five-year survival now exceeds 70-80%. Childhood exposure to radiation is a known thyroid carcinogen; however, data are limited for the evaluation of radiation dose-response at high doses, modifiers of the dose-response relationship and joint effects of radiotherapy and chemotherapy. To address these issues, we pooled two cohort and two nested case-control studies of childhood cancer survivors including 16,757 patients, with 187 developing primary thyroid cancer. Relative risks (RR) with 95% confidence intervals (CI) for thyroid cancer by treatment with alkylating agents, anthracyclines or bleomycin were 3.25 (0.9-14.9), 4.5 (1.4-17.8) and 3.2 (0.8-10.4), respectively, in patients without radiotherapy, and declined with greater radiation dose (RR trends, P = 0.02, 0.12 and 0.01, respectively). Radiation dose-related RRs increased approximately linearly for &lt;10 Gy, leveled off at 10-15-fold for 10-30 Gy and then declined, but remained elevated for doses &gt;50 Gy. The fitted RR at 10 Gy was 13.7 (95% CI: 8.0-24.0). Dose-related excess RRs increased with decreasing age at exposure (P &lt; 0.01), but did not vary with attained age or time-since-exposure, remaining elevated 25+ years after exposure. Gender and number of treatments did not modify radiation effects. Thyroid cancer risks remained elevated many decades following radiotherapy, highlighting the need for continued follow up of childhood cancer survivors. (C) 2012 by Radiation Research Society},
  author       = {Veiga, Lene H. S. and Lubin, Jay H. and Anderson, Harald and de Vathaire, Florent and Tucker, Margaret and Bhatti, Parveen and Schneider, Arthur and Johansson, Robert and Inskip, Peter and Kleinerman, Ruth and Shore, Roy and Pottern, Linda and Holmberg, Erik and Hawkins, Michael M. and Adams, M. Jacob and Sadetzki, Siegal and Lundell, Marie and Sakata, Ritsu and Damber, Lena and Neta, Gila and Ron, Elaine},
  issn         = {0033-7587},
  language     = {eng},
  number       = {4},
  pages        = {365--376},
  publisher    = {Radiation Research Society},
  series       = {Radiation Research},
  title        = {A Pooled Analysis of Thyroid Cancer Incidence Following Radiotherapy for Childhood Cancer},
  url          = {http://dx.doi.org/10.1667/RR2889.1},
  volume       = {178},
  year         = {2012},
}