Estimation of Radiation-Induced Secondary Cancer Risk in Lung Cancer Patients Following Three-Dimensional Conformal Radiotherapy
-
Maryam Khalid
,
Mahdi Ghorbani
,
Mohammad Ali Tajik-Mansoury
,
Mohammad Mojahed
,
Mehdi Khosravi
,
Meysam Tavakoli
Abstract
Purpose: Lung cancer treatment often involves radiotherapy, which can lead to an increased risk of secondary cancers in sensitive organs and Organs At Risk (OARs). Understanding this risk is crucial for optimizing treatment strategies and minimizing long-term adverse effects. The objective of this study is to estimate the Secondary Cancer Risks (SCRs) in sensitive organs and OARs using radiation-induced cancer risk prediction models, specifically the Biological Effects of Ionizing Radiation (BEIR) VII model and the International Commission on Radiological Protection (ICRP) model.
Materials and Methods: The radiotherapy dosimetric data of 30 lung cancer patients were collected all of whom underwent Computed Tomography (CT) scans. The PCRT-3D Treatment Planning System (TPS) was used for the treatment planning process. The risks were calculated based on the dose distribution in the target volume. The models for Excess Absolute Risk (EAR) and Excess Relative Risk (ERR) values (per 100,000 person-year) were utilized to estimate SCRs in planning target volume, OARs, and sensitive organs.
Results: The results indicate that, according to the BEIR VII model, the estimated EAR of cancer per 100,000 person-years was 38.39 in the heart, 35.83 in the esophagus, 5.49 in the contralateral lung, 2.17 in the liver, and 3.41 in the pancreas. Conversely, using the ICRP model, the EAR was calculated to be 58.73 in the heart, 38.78 in the esophagus, 20.48 in the contralateral lung, 3.49 in the liver, and 5.44 in the pancreas. These findings suggest that lung cancer patients treated with 3DCRT exhibit relatively high SCRs in the heart, esophagus, and contralateral lung organs in both models.
Conclusion: In this study, SCRs in a range of organs in lung cancer patients treated with 3DCRT were quantified. Our findings revealed that there were comparatively high SCRs in the heart in 3DCRT of lung cancer patients. Based on the findings of the current investigation, the ICRP model SCRs are greater in comparison to the BEIR VII model. These findings underscore the importance of considering SCRs in treatment planning and highlight the need for further research to optimize radiation therapy strategies and minimize long-term risks for lung cancer patients.
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32- Dong Wook Kim et al., "Risk of second cancer from scattered radiation of intensity-modulated radiotherapies with lung cancer." Radiation oncology, Vol. 8pp. 1-8, (2013).
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38- Sarah C Darby et al., "Radiation-related heart disease: current knowledge and future prospects." International Journal of Radiation Oncology* Biology* Physics, Vol. 76 (No. 3), pp. 656-65, (2010).
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40- Roy E Shore, "Issues and epidemiological evidence regarding radiation-induced thyroid cancer." Radiation research, Vol. 131 (No. 1), pp. 98-111, (1992).
41- Ibrahima Diallo et al., "Frequency distribution of second solid cancer locations in relation to the irradiated volume among 115 patients treated for childhood cancer." International Journal of Radiation Oncology* Biology* Physics, Vol. 74 (No. 3), pp. 876-83, (2009).
42- Douglas G Gold, Joseph P Neglia, Roger A Potish, and Kathryn E Dusenbery, "Second neoplasms following megavoltage radiation for pediatric tumors." Cancer: Interdisciplinary International Journal of the American Cancer Society, Vol. 100 (No. 1), pp. 212-13, (2004).
2- Daniela Moye-Holz et al., "Availability, prices, and affordability of selected essential cancer medicines in a middle-income country–the case of Mexico." BMC health services research, Vol. 20 (No. 1), p. 424, (2020).
3- Reanne Booker, "A brief report on the 2020 Canadian Global Oncology Workshop." Canadian OnCOlOgy nursing JOurnal, Vol. 31 (No. 3), p. 345, (2021).
4- Laura E MacConaill, Paul Van Hummelen, Matthew Meyerson, and William C Hahn, "Clinical implementation of comprehensive strategies to characterize cancer genomes: opportunities and challenges." Cancer discovery, Vol. 1 (No. 4), pp. 297-311, (2011).
5- Iuliana Toma-Dasu, Andrzej Wojcik, and Emely Kjellsson Lindblom, "Risk of second cancer following radiotherapy." Physica Medica, Vol. 42pp. 211-12, (2017).
6- Early Breast Cancer Trialists' Collaborative Group, "Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials." The Lancet, Vol. 366 (No. 9503), pp. 2087-106, (2005).
7- Early Breast Cancer Trialists' Collaborative Group, "Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10 801 women in 17 randomised trials." The Lancet, Vol. 378 (No. 9804), pp. 1707-16, (2011).
8- Overgaard M Hansen PS, J Overgaard, C Rose, M Andersson, and F Bach, "Postoperative radiotheraphy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. Danish Breast Cancer Cooperative Group 82b Trial." N Engl J Med, Vol. 337 (No. 14), pp. 949-55, (1997).
9- Marie Overgaard, "Postoperative radiotherapy in high-risk postmenopausal breast cancer." The Lancet, Vol. 354 (No. 9181), p. 866, (1999).
10- DLW Kwong et al., "Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials." The Lancet, (2014).
11- Shalini K Vinod and Eric Hau, "Radiotherapy treatment for lung cancer: Current status and future directions." Respirology, Vol. 25pp. 61-71, (2020).
12- Uwe Schneider, Daniel Zwahlen, Dieter Ross, and Barbara Kaser-Hotz, "Estimation of radiation-induced cancer from three-dimensional dose distributions: Concept of organ equivalent dose." International Journal of Radiation Oncology* Biology* Physics, Vol. 61 (No. 5), pp. 1510-15, (2005).
13- Uwe Schneider, Marcin Sumila, Judith Robotka, Günther Gruber, Andreas Mack, and Jürgen Besserer, "Dose-response relationship for breast cancer induction at radiotherapy dose." Radiation oncology, Vol. 6pp. 1-7, (2011).
14- Abel Russ, Casey Burns, Seth Tuler, and Octavia Taylor, "Health risks of ionizing radiation: an overview of epidemiological studies." (2006).
15- Torunn I Yock and Paul A Caruso, "Risk of second cancers after photon and proton radiotherapy: a review of the data." Health physics, Vol. 103 (No. 5), pp. 577-85, (2012).
16- Steven G Sutlief, "Protection and measurement in radiation therapy." Health physics, Vol. 108 (No. 2), pp. 224-41, (2015).
17- David J Pawel and Jerome S Puskin, "US Environmental Protection Agency radiogenic risk models and projections for the US population." Health physics, Vol. 102 (No. 6), pp. 646-56, (2012).
18- R Roychoudhuri, H Evans, D Robinson, and H Møller, "Radiation-induced malignancies following radiotherapy for breast cancer." British journal of cancer, Vol. 91 (No. 5), pp. 868-72, (2004).
19- David J Brenner and Rainer K Sachs, "Estimating radiation-induced cancer risks at very low doses: rationale for using a linear no-threshold approach." Radiation and environmental biophysics, Vol. 44pp. 253-56, (2006).
20- Michael Schaapveld et al., "Risk of new primary nonbreast cancers after breast cancer treatment: a Dutch population-based study." Journal of Clinical Oncology, Vol. 26 (No. 8), pp. 1239-46, (2008).
21- Jacob Adams et al., "Thyroid cancer risk 40+ years after irradiation for an enlarged thymus: an update of the Hempelmann cohort." Radiation research, Vol. 174 (No. 6a), pp. 753-62, (2010).
22- A Berrington de Gonzalez et al., "Second solid cancers after radiotherapy for breast cancer in SEER cancer registries." British journal of cancer, Vol. 102 (No. 1), pp. 220-26, (2010).
23- Trine Grantzau, Lene Mellemkjær, and Jens Overgaard, "Second primary cancers after adjuvant radiotherapy in early breast cancer patients: a national population based study under the Danish Breast Cancer Cooperative Group (DBCG)." Radiotherapy and Oncology, Vol. 106 (No. 1), pp. 42-49, (2013).
24- Xueying Qiao, Owe Tullgren, Ingmar Lax, Florin Sirzén, and Rolf Lewensohn, "The role of radiotherapy in treatment of stage I non-small cell lung cancer." Lung cancer, Vol. 41 (No. 1), pp. 1-11, (2003).
25- George Rodrigues, Michael Lock, David D'Souza, Edward Yu, and Jake Van Dyk, "Prediction of radiation pneumonitis by dose–volume histogram parameters in lung cancer—a systematic review." Radiotherapy and Oncology, Vol. 71 (No. 2), pp. 127-38, (2004).
26- Radiological Protection, "ICRP publication 103." Ann ICRP, Vol. 37 (No. 2.4), p. 2, (2007).
27- David A Schauer and Otha W Linton, "National Council on Radiation Protection and Measurements report shows substantial medical exposure increase." Vol. 253, ed: Radiological Society of North America, Inc., (2009), pp. 293-96.
28- Radiation UNSCotEoA, "Effects of ionizing radiation: UNSCEAR 2006 Report to the General Assembly, with scientific annexes." Place United Nations Publications: United Nations Publications, (2009).
29- National Research Council and BEIR VII-Phase, "2, Health risks from exposure to low levels of ionizing radiation." ed: Washington, DC: The National Academies Press, (2005).
30- Eric J Hall and Cheng-Shie Wuu, "Radiation-induced second cancers: the impact of 3D-CRT and IMRT." International Journal of Radiation Oncology* Biology* Physics, Vol. 56 (No. 1), pp. 83-88, (2003).
31- Pei-Ju Chao et al., "Radiation-induced secondary cancer risk assessment in patients with lung cancer after stereotactic body radiotherapy using the CyberKnife M6 system with lung-optimized treatment." Frontiers in Bioengineering and Biotechnology, Vol. 8p. 306, (2020).
32- Dong Wook Kim et al., "Risk of second cancer from scattered radiation of intensity-modulated radiotherapies with lung cancer." Radiation oncology, Vol. 8pp. 1-8, (2013).
33- Seonkyu Kim et al., "Secondary radiation doses of intensity-modulated radiotherapy and proton beam therapy in patients with lung and liver cancer." Radiotherapy and oncology, Vol. 98 (No. 3), pp. 335-39, (2011).
34- Nornadiah Mohd Razali and Yap Bee Wah, "Power comparisons of shapiro-wilk, kolmogorov-smirnov, lilliefors and anderson-darling tests." Journal of statistical modeling and analytics, Vol. 2 (No. 1), pp. 21-33, (2011).
35- Bahman Emami et al., "Tolerance of normal tissue to therapeutic irradiation." International Journal of Radiation Oncology* Biology* Physics, Vol. 21 (No. 1), pp. 109-22, (1991).
36- Quanbin Zhang et al., "Secondary cancer risk after radiation therapy for breast cancer with different radiotherapy techniques." Scientific reports, Vol. 10 (No. 1), p. 1220, (2020).
37- A Belliere et al., "Feasibility of high-dose three-dimensional radiation therapy in the treatment of localised non-small-cell lung cancer." Cancer/Radiothérapie, Vol. 13 (No. 4), pp. 298-304, (2009).
38- Sarah C Darby et al., "Radiation-related heart disease: current knowledge and future prospects." International Journal of Radiation Oncology* Biology* Physics, Vol. 76 (No. 3), pp. 656-65, (2010).
39- Gudrun Svahn-Tapper et al., "Radiation dose and relapse are predictors for development of second malignant solid tumors after cancer in childhood and adolescence: a population-based case-control study in the five Nordic countries." Acta Oncologica, Vol. 45 (No. 4), pp. 438-48, (2006).
40- Roy E Shore, "Issues and epidemiological evidence regarding radiation-induced thyroid cancer." Radiation research, Vol. 131 (No. 1), pp. 98-111, (1992).
41- Ibrahima Diallo et al., "Frequency distribution of second solid cancer locations in relation to the irradiated volume among 115 patients treated for childhood cancer." International Journal of Radiation Oncology* Biology* Physics, Vol. 74 (No. 3), pp. 876-83, (2009).
42- Douglas G Gold, Joseph P Neglia, Roger A Potish, and Kathryn E Dusenbery, "Second neoplasms following megavoltage radiation for pediatric tumors." Cancer: Interdisciplinary International Journal of the American Cancer Society, Vol. 100 (No. 1), pp. 212-13, (2004).
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How to Cite
1.
Khalid M, Ghorbani M, Tajik-Mansoury MA, Mojahed M, Khosravi M, Tavakoli M. Estimation of Radiation-Induced Secondary Cancer Risk in Lung Cancer Patients Following Three-Dimensional Conformal Radiotherapy. Frontiers Biomed Technol. 2024;.
