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Title: Radiation Dose and Subsequent Risk for Stomach Cancer in Long-term Survivors of Cervical Cancer

Purpose: To assess the dose–response relationship for stomach cancer after radiation therapy for cervical cancer. Methods and Materials: We conducted a nested, matched case–control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, P{sub trend}=.047) compared with nonirradiated women. A highly significant radiation dose–response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (P{sub trend}=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57more » controls) whose cancer was located in the upper stomach (P{sub trend}=.23). Conclusions: Our findings show for the first time a significant linear dose–response relationship for risk of stomach cancer in long-term survivors of cervical cancer.« less
 [1] ;  [2] ;  [3] ;  [4] ;  [5] ;  [6] ; ;  [2] ;  [1] ;  [7] ;  [8] ;  [9] ;  [10] ;  [6] ;  [11] ;
  1. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland (United States)
  2. Department of Radiation Physics, University of Texas M D Anderson Cancer Center, Houston, Texas (United States)
  3. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario (Canada)
  4. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm (Sweden)
  5. Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki (Finland)
  6. Department of Oncology, Helsinki University Central Hospital, Helsinki (Finland)
  7. Department of Radiotherapy, The Netherlands Cancer Institute, Amsterdam (Netherlands)
  8. Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm (Sweden)
  9. Department of Oncology, Copenhagen University Hospital, Copenhagen (Denmark)
  10. Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen (Denmark)
  11. Department of Epidemiology, University of Iowa, Iowa City, Iowa (United States)
Publication Date:
OSTI Identifier:
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 86; Journal Issue: 5; Other Information: Copyright (c) 2013 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States