International journal of radiation oncology, biology, physics · 2010
Role of radiation dose in the risk of secondary leukemia after a solid tumor in childhood treated between 1980 and 1999.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Allard Aurore, Haddy Nadia, Le Deley Marie-Cécile, Rubino Carole, Lassalle Mathilde, Samsaldin Akthar, Quiniou Eric, Chompret Agnès, Lefkopoulos Dimitri, Diallo Ibrahima, de Vathaire Florent
Аннотация
PURPOSE: The purpose of this study was to estimate the risk of secondary leukemia as a function of radiation dose, taking into account heterogeneous radiation dose distribution.
METHODS AND MATERIALS: We analyzed a case-control study that investigated the risk of secondary leukemia and myelodysplasia after a solid tumor in childhood; it included 61 patients with leukemia matched with 196 controls. Complete clinical, chemotherapy, and radiotherapy histories were recorded for each patient in the study. Average radiation dose to each of seven bone marrow components for each patient was incorporated into the models, and corresponding risks were summed up. Conditional maximum likelihood methods were used to estimate risk parameters.
RESULTS: Whatever the model, we failed to evidence a role for the radiation dose to active bone marrow in the risk of later leukemia, myelodysplasia, or myeloproliferative syndrome, when adjusting for epipodophyllotoxin and anthracycline doses. This result was confirmed when fitting models that included total dose of radiation delivered during radiotherapy, when fitting models taking into account dose per fraction, and when restricting the analysis to acute myeloid leukemia.
CONCLUSIONS: In contrast to results found in similar studies that included children treated before the use of epipodophyllotoxins, this study failed to show a role for radiotherapy in the risk of secondary leukemia after childhood cancer in children treated between 1980 and 1999. This discrepancy was probably due to a competitive mechanism between these two carcinogens.
METHODS AND MATERIALS: We analyzed a case-control study that investigated the risk of secondary leukemia and myelodysplasia after a solid tumor in childhood; it included 61 patients with leukemia matched with 196 controls. Complete clinical, chemotherapy, and radiotherapy histories were recorded for each patient in the study. Average radiation dose to each of seven bone marrow components for each patient was incorporated into the models, and corresponding risks were summed up. Conditional maximum likelihood methods were used to estimate risk parameters.
RESULTS: Whatever the model, we failed to evidence a role for the radiation dose to active bone marrow in the risk of later leukemia, myelodysplasia, or myeloproliferative syndrome, when adjusting for epipodophyllotoxin and anthracycline doses. This result was confirmed when fitting models that included total dose of radiation delivered during radiotherapy, when fitting models taking into account dose per fraction, and when restricting the analysis to acute myeloid leukemia.
CONCLUSIONS: In contrast to results found in similar studies that included children treated before the use of epipodophyllotoxins, this study failed to show a role for radiotherapy in the risk of secondary leukemia after childhood cancer in children treated between 1980 and 1999. This discrepancy was probably due to a competitive mechanism between these two carcinogens.
Предметные рубрики MeSH
AdolescentAlgorithmsAnthracyclinesAntibiotics, AntineoplasticAntineoplastic Agents, PhytogenicBone MarrowCase-Control StudiesChildChild, PreschoolDose-Response Relationship, RadiationFemaleFranceHumansInfantInfant, NewbornLeukemia, Myeloid, AcuteLeukemia, Radiation-InducedLikelihood FunctionsMaleMyelodysplastic SyndromesMyeloproliferative DisordersNeoplasmsPodophyllotoxinPrecursor Cell Lymphoblastic Leukemia-LymphomaRadiotherapy DosageRisk Assessment