Radiation dose and leukemia risk in patients treated for cancer of the cervix

Journal Article · Tue Dec 01 04:00:00 EST 1987 · J. Natl. Cancer Inst.; (United States)

OSTI ID:5467705

Boice, Jr, J D; Blettner, M; Kleinerman, R A; Stovall, M; Moloney, W C; Engholm, G; Austin, D F; Bosch, A; Cookfair, D L; Krementz, E T

To quantify the risk of radiation-induced leukemia and provide further information on the nature of the relationship between dose and response, a case-control study was undertaken in a cohort of over 150,000 women with invasive cancer of the uterine cervix. The cases either were reported to one of 17 population-based cancer registries or were treated in any of 16 oncologic clinics in Canada, Europe, and the United States. Four controls were individually matched to each of 195 cases of leukemia on the basis of age and calendar year when diagnosed with cervical cancer and survival time. Leukemia diagnoses were verified by one hematologist. Radiation dose to active bone marrow was estimated by medical physicists on the basis of the original radiotherapy records of study subjects. The risk of chronic lymphocytic leukemia, one of the few malignancies without evidence for an association with ionizing radiation, was not increased (relative risk (RR) = 1.03; n = 52). However, for all other forms of leukemia taken together (n = 143), a twofold risk was evident (RR = 2.0; 90% confidence interval = 1.0-4.2). Risk increased with increasing radiation dose until average doses of about 400 rad (4 Gy) were reached and then decreased at higher doses. This pattern is consistent with experimental data for which the down-turn in risk at high doses has been interpreted as due to killing of potentially leukemic cells. The dose-response information was modeled with various RR functions, accounting for the nonhomogeneous distribution of radiation dose during radiotherapy. The local radiation doses to each of 14 bone marrow compartments for each patient were incorporated in the models, and the corresponding risks were summed.

• Research Organization: National Cancer Institute, Bethesda, MD
• OSTI ID: 5467705
• Journal Information: J. Natl. Cancer Inst.; (United States), Journal Name: J. Natl. Cancer Inst.; (United States) Vol. 79:6; ISSN JNCIA
• Country of Publication: United States
• Language: English

Related Subjects

550603 -- Medicine-- External Radiation in Therapy-- (1980-)
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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
ANIMAL TISSUES
BODY
BONE MARROW
DISEASES
DOSE-RESPONSE RELATIONSHIPS
DOSES
EUROPE
FEMALE GENITALS
HEMATOPOIETIC SYSTEM
HEMIC DISEASES
LEUKEMIA
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATIENTS
RADIATION DOSES
RADIOINDUCTION
RADIOLOGY
RADIOTHERAPY
RISK ASSESSMENT
SIDE EFFECTS
THERAPY
TISSUES
UTERUS