Role of Radiation Dose in the Risk of Secondary Leukemia After a Solid Tumor in Childhood Treated Between 1980 and 1999

Journal Article · Wed Dec 01 00:00:00 EST 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.09.032· OSTI ID:21491517

Allard, Aurore; Haddy, Nadia; Le Deley, Marie-Cecile; Rubino, Carole; Lassalle, Mathilde; Samsaldin, Akthar ^[1]; Univ Paris-Sud, Villejuif ^[2]; Quiniou, Eric ^[3]; Chompret, Agnes; Lefkopoulos, Dimitri ^[4]; Diallo, Ibrahima ^[1]; Univ Paris-Sud, Villejuif ^[2]; Univ Paris-Sud, Villejuif ^[2]

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1. INSERM Unit 605, Villejuif (France)
2. France
3. INSERM Unit 759, Orsay (France)
4. Institut Gustave Roussy, Villejuif (France)

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.

• OSTI ID: 21491517
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 78, Issue 5; Other Information: DOI: 10.1016/j.ijrobp.2009.09.032; PII: S0360-3016(09)03274-X; Copyright (c) 2010 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BONE MARROW
CHILDREN
MYELOID LEUKEMIA
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIATION HAZARDS
RADIOTHERAPY
AGE GROUPS
ANIMAL TISSUES
ANIMALS
BODY
DISEASES
DOSES
HAZARDS
HEALTH HAZARDS
HEMATOPOIETIC SYSTEM
IMMUNE SYSTEM DISEASES
LEUKEMIA
MAMMALS
MAN
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PRIMATES
RADIOLOGY
THERAPY
VERTEBRATES