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Title: Cancer risk estimation of genotoxic chemicals based on target dose and a multiplicative model

Abstract

A mechanistic model and associated procedures are proposed for cancer risk assessment of genotoxic chemicals. As previously shown for ionizing radiation, a linear multiplicative model was found to be compatible with published experimental data for ethylene oxide, acrylamide, and butadiene. Concurrent analysis led to rejection of an additive model. A reanalysis of data for radiogenic cancer in mouse, dog and man shows that the relative risk coefficient is approximately the same for tumors induced in the three species. Doses in vivo, defined as the time-integrated concentrations of ultimate mutagens, expressed in millimol x kg[sup [minus]1] x h (mMh) are, like radiation doses given in Gy or rad, proportional to frequencies of potentially mutagenic events. The radiation dose equivalents of chemical doses are, calculated by multiplying chemical doses (in mMh) with the relative genotoxic potencies determined in vitro. In this way the relative cancer incidence increments in rats and mice exposed to ethylene oxide were shown to be about 0.4% per rad-equivalent, in agreement with the data for radiogenic cancer. The analyses suggest that values of the relative risk coefficients for genotoxic chemicals are independent of species and that relative cancer risks determined in animal tests apply also to humans. Ifmore » reliable animal test data are not available, cancer risks may be estimated by the relative potency. In both cases exposure dose/target dose relationships, the latter via macromolecule adducts, should be determined.« less

Authors:
 [1];  [2]; ;  [3]
  1. (Stockholm Univ. (Sweden). Dept. of Mathematical Statistics Karolinska Inst., Stockholm (Sweden). Dept. of Medical Epidemiology)
  2. (Stockholm Univ. (Sweden). Dept. of Radiobiology Casco Products AB, Stockholm (Sweden))
  3. (Stockholm Univ. (Sweden))
Publication Date:
Sponsoring Org.:
USDOE; USDOE, Washington, DC (United States)
OSTI Identifier:
6277640
DOE Contract Number:
FG02-89ER60784
Resource Type:
Journal Article
Resource Relation:
Journal Name: Risk Analysis; Journal Volume: 19:2
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; ACRYLAMIDE; BIOLOGICAL MODELS; BUTADIENE; CARCINOGENESIS; ETHYLENE; EXPERIMENTAL NEOPLASMS; MATHEMATICAL MODELS; RISK ASSESSMENT; ALKENES; AMIDES; DIENES; HYDROCARBONS; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; PATHOGENESIS; POLYENES; 560300* - Chemicals Metabolism & Toxicology

Citation Formats

Granath, F.N., Vaca, C.E., Ehrenberg, L.G., and Toernqvist, M.A. Cancer risk estimation of genotoxic chemicals based on target dose and a multiplicative model. United States: N. p., 1999. Web. doi:10.1023/A:1006933913194.
Granath, F.N., Vaca, C.E., Ehrenberg, L.G., & Toernqvist, M.A. Cancer risk estimation of genotoxic chemicals based on target dose and a multiplicative model. United States. doi:10.1023/A:1006933913194.
Granath, F.N., Vaca, C.E., Ehrenberg, L.G., and Toernqvist, M.A. 1999. "Cancer risk estimation of genotoxic chemicals based on target dose and a multiplicative model". United States. doi:10.1023/A:1006933913194.
@article{osti_6277640,
title = {Cancer risk estimation of genotoxic chemicals based on target dose and a multiplicative model},
author = {Granath, F.N. and Vaca, C.E. and Ehrenberg, L.G. and Toernqvist, M.A.},
abstractNote = {A mechanistic model and associated procedures are proposed for cancer risk assessment of genotoxic chemicals. As previously shown for ionizing radiation, a linear multiplicative model was found to be compatible with published experimental data for ethylene oxide, acrylamide, and butadiene. Concurrent analysis led to rejection of an additive model. A reanalysis of data for radiogenic cancer in mouse, dog and man shows that the relative risk coefficient is approximately the same for tumors induced in the three species. Doses in vivo, defined as the time-integrated concentrations of ultimate mutagens, expressed in millimol x kg[sup [minus]1] x h (mMh) are, like radiation doses given in Gy or rad, proportional to frequencies of potentially mutagenic events. The radiation dose equivalents of chemical doses are, calculated by multiplying chemical doses (in mMh) with the relative genotoxic potencies determined in vitro. In this way the relative cancer incidence increments in rats and mice exposed to ethylene oxide were shown to be about 0.4% per rad-equivalent, in agreement with the data for radiogenic cancer. The analyses suggest that values of the relative risk coefficients for genotoxic chemicals are independent of species and that relative cancer risks determined in animal tests apply also to humans. If reliable animal test data are not available, cancer risks may be estimated by the relative potency. In both cases exposure dose/target dose relationships, the latter via macromolecule adducts, should be determined.},
doi = {10.1023/A:1006933913194},
journal = {Risk Analysis},
number = ,
volume = 19:2,
place = {United States},
year = 1999,
month = 4
}
  • Purpose: The aim of this study was to evaluate the impact of variations in pelvic dimensions on the dose delivered to the target volumes and the organs at risk (OARs) in patients with high-risk prostate cancer (PCa) to be treated with whole pelvic radiation therapy (WPRT) in an attempt to define the hostile pelvis in terms of intensity modulated radiation therapy (IMRT). Methods and Materials: In 45 men with high-risk PCa to be treated with WPRT, the target volumes and the OARs were delineated, the dose constraints for the OARs were defined, and treatment plans were generated according to themore » Radiation Therapy Oncology Group 0924 protocol. Six dimensions to reflect the depth, width, and height of the bony pelvis were measured, and 2 indexes were calculated from the planning computed tomographic scans. The minimum dose (D{sub min}), maximum dose (D{sub max}), and mean dose (D{sub mean}) for the target volumes and OARs and the partial volumes of each of these structures receiving a specified dose (V{sub D}) were calculated from the dose-volume histograms (DVHs). The data from the DVHs were correlated with the pelvic dimensions and indexes. Results: According to an overall hostility score (OHS) calculation, 25 patients were grouped as having a hospitable pelvis and 20 as having a hostile pelvis. Regarding the OHS grouping, the DVHs for the bladder, bowel bag, left femoral head, and right femoral head differed in favor of the hospitable pelvis group, and the DVHs for the rectum differed for a range of lower doses in favor of the hospitable pelvis group. Conclusions: Pelvimetry might be used as a guide to define the challenging anatomy or the hostile pelvis in terms of treatment planning for IMRT in patients with high-risk PCa to be treated with WPRT.« less
  • Purpose: Previous measurements with Bonner spheres{sup 1} showed that normalized neutron spectra are equal for the majority of the existing linacs{sup 2}. This information, in addition to thermal neutron fluences obtained in the characterization procedure{sup 3}3, would allow to estimate neutron doses accidentally received by exposed workers, without the need of an extra experimental measurement. Methods: Monte Carlo (MC) simulations demonstrated that the thermal neutron fluence distribution inside the bunker is quite uniform, as a consequence of multiple scatter in the walls{sup 4}. Although inverse square law is approximately valid for the fast component, a more precise calculation could bemore » obtained with a generic fast fluence distribution map around the linac, from MC simulations{sup 4}. Thus, measurements of thermal neutron fluences performed during the characterization procedure{sup 3}, together with a generic unitary spectra{sup 2}, would allow to estimate the total neutron fluences and H*(10) at any point{sup 5}. As an example, we compared estimations with Bonner sphere measurements{sup 1}, for two points in five facilities: 3 Siemens (15–23 MV), Elekta (15 MV) and Varian (15 MV). Results: Thermal neutron fluences obtained from characterization, are within (0.2–1.6×10{sup 6}) cm−{sup 2}•Gy{sup −1} for the five studied facilities. This implies ambient equivalent doses ranging from (0.27–2.01) mSv/Gy 50 cm far from the isocenter and (0.03–0.26) mSv/Gy at detector location with an average deviation of ±12.1% respect to Bonner measurements. Conclusion: The good results obtained demonstrate that neutron fluence and H*(10) can be estimated based on: (a) characterization procedure established for patient risk estimation in each facility, (b) generic unitary neutron spectrum and (c) generic MC map distribution of the fast component. [1] Radiat. Meas (2010) 45: 1391 – 1397; [2] Phys. Med. Biol (2012) 5 7:6167–6191; [3] Med. Phys (2015) 42:276 - 281. [4] IFMBE (2012) 39: 1245–1248. [5] ICRU Report 57 (1998)« less
  • Cytogenetic endpoints, conventionally chromosomal aberrations, and later sister chromatid exchanges and micronuclei have long been used to assess exposure of human populations to genotoxic agents. Although the adverse nature of somatic chromosome damage is recognized at the group level, no ill-health manifestations have been causally related to cytogenetic damage at the individual level. In work-related exposures, e.g., ethylene oxide, styrene, benzene, vinyl chloride, and alkylating anticancer agents have been shown to induce somatic chromosomal damage in several studies. For all of these, a carcinogenic risk to humans has also been documented. The possible association of somatic chromosome damage and cancermore » will be elucidated in a Nordic prospective study. The objective is to find out the significance of a high or low score in any of the cytogenetic parametres to risk of cancer. In the Finnish part of the cohort of 806 individuals, 10 cases of cancer were observed during the first follow-up period. Although the cohort is young and the numbers small, a slightly significant (P = 0.04) trend was observed for individuals with cancer and a score of chromosomal aberrations. No trend was observed for sister chromatid exchanges. The application of cytogenetic surveillance is still not routine methodology, but it is useful and informative in carefully controlled study designs. Special efforts should be directed toward combining different disciplines, i.e., cytogenetics, adduct monitoring, and end-effect epidemiology, in order to reach quantitativeness in risk assessment.13 references.« less
  • Purpose: Radiation-dose awareness and optimization in CT can greatly benefit from a dose-reporting system that provides dose and risk estimates specific to each patient and each CT examination. As the first step toward patient-specific dose and risk estimation, this article aimed to develop a method for accurately assessing radiation dose from CT examinations. Methods: A Monte Carlo program was developed to model a CT system (LightSpeed VCT, GE Healthcare). The geometry of the system, the energy spectra of the x-ray source, the three-dimensional geometry of the bowtie filters, and the trajectories of source motions during axial and helical scans weremore » explicitly modeled. To validate the accuracy of the program, a cylindrical phantom was built to enable dose measurements at seven different radial distances from its central axis. Simulated radial dose distributions in the cylindrical phantom were validated against ion chamber measurements for single axial scans at all combinations of tube potential and bowtie filter settings. The accuracy of the program was further validated using two anthropomorphic phantoms (a pediatric one-year-old phantom and an adult female phantom). Computer models of the two phantoms were created based on their CT data and were voxelized for input into the Monte Carlo program. Simulated dose at various organ locations was compared against measurements made with thermoluminescent dosimetry chips for both single axial and helical scans. Results: For the cylindrical phantom, simulations differed from measurements by -4.8% to 2.2%. For the two anthropomorphic phantoms, the discrepancies between simulations and measurements ranged between (-8.1%, 8.1%) and (-17.2%, 13.0%) for the single axial scans and the helical scans, respectively. Conclusions: The authors developed an accurate Monte Carlo program for assessing radiation dose from CT examinations. When combined with computer models of actual patients, the program can provide accurate dose estimates for specific patients.« less
  • Purpose: Current methods for estimating and reporting radiation dose from CT examinations are largely patient-generic; the body size and hence dose variation from patient to patient is not reflected. Furthermore, the current protocol designs rely on dose as a surrogate for the risk of cancer incidence, neglecting the strong dependence of risk on age and gender. The purpose of this study was to develop a method for estimating patient-specific radiation dose and cancer risk from CT examinations. Methods: The study included two patients (a 5-week-old female patient and a 12-year-old male patient), who underwent 64-slice CT examinations (LightSpeed VCT, GEmore » Healthcare) of the chest, abdomen, and pelvis at our institution in 2006. For each patient, a nonuniform rational B-spine (NURBS) based full-body computer model was created based on the patient's clinical CT data. Large organs and structures inside the image volume were individually segmented and modeled. Other organs were created by transforming an existing adult male or female full-body computer model (developed from visible human data) to match the framework defined by the segmented organs, referencing the organ volume and anthropometry data in ICRP Publication 89. A Monte Carlo program previously developed and validated for dose simulation on the LightSpeed VCT scanner was used to estimate patient-specific organ dose, from which effective dose and risks of cancer incidence were derived. Patient-specific organ dose and effective dose were compared with patient-generic CT dose quantities in current clinical use: the volume-weighted CT dose index (CTDI{sub vol}) and the effective dose derived from the dose-length product (DLP). Results: The effective dose for the CT examination of the newborn patient (5.7 mSv) was higher but comparable to that for the CT examination of the teenager patient (4.9 mSv) due to the size-based clinical CT protocols at our institution, which employ lower scan techniques for smaller patients. However, the overall risk of cancer incidence attributable to the CT examination was much higher for the newborn (2.4 in 1000) than for the teenager (0.7 in 1000). For the two pediatric-aged patients in our study, CTDI{sub vol} underestimated dose to large organs in the scan coverage by 30%-48%. The effective dose derived from DLP using published conversion coefficients differed from that calculated using patient-specific organ dose values by -57% to 13%, when the tissue weighting factors of ICRP 60 were used, and by -63% to 28%, when the tissue weighting factors of ICRP 103 were used. Conclusions: It is possible to estimate patient-specific radiation dose and cancer risk from CT examinations by combining a validated Monte Carlo program with patient-specific anatomical models that are derived from the patients' clinical CT data and supplemented by transformed models of reference adults. With the construction of a large library of patient-specific computer models encompassing patients of all ages and weight percentiles, dose and risk can be estimated for any patient prior to or after a CT examination. Such information may aid in decisions for image utilization and can further guide the design and optimization of CT technologies and scan protocols.« less