TUMORS OF THE BRAIN AND NERVOUS-SYSTEM AFTER RADIOTHERAPY IN CHILDHOOD
TUMORS OF THE BRAIN AND NERVOUS-SYSTEM AFTER RADIOTHERAPY IN CHILDHOOD
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DOI：
10.1056/nejm198810203191601
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发表时间：
1988-10-20
影响因子：
158.5
通讯作者：
KATZ, L
中科院分区：
文献类型：
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作者：
RON, E;MODAN, B;KATZ, L
我们调查了1948年至1960年间以色列10，834例接受治疗的儿童期头颈部肿瘤放疗与脑和神经系统肿瘤后期发展之间的关系。良性和恶性肿瘤是根据所有以色列医院的病理记录以及以色列国家癌症和死亡登记处确定的。回顾性估计每例患者的神经组织辐射剂量（平均值为1.5戈伊）。60例神经肿瘤发生在儿童时期，30年累积风险（. ±. SE）为0.8 ±。0.2百分之肿瘤发病率为每年每10 000人1.8例。与10，834名匹配的一般人群对照和5392名未接受辐射的同胞相比，所有肿瘤的估计相对风险为6.9（95%置信区间，4.1至11.6），当分析仅限于头颈部神经肿瘤时，为8.4（置信区间，4.8至14.8）。脑膜瘤（相对风险，9.5; n = 19）、神经胶质瘤（相对风险，2.6; n = 7）、神经鞘瘤（相对风险，18.8; n = 25）和其他神经肿瘤（相对风险，3.4; n = 9）的风险明显增加。一个强大的剂量反应关系，发现，与相对风险接近20后，估计剂量约为2.5戈伊。我们的研究证实，辐射剂量在1至2戈伊的顺序可以显着增加神经肿瘤的风险。
We investigated the relation between radiotherapy in childhood for tinea capitis and the later development of tumors of the brain and nervous system among 10,834 patients treated between 1948 and 1960 in Israel. Benign and malignant tumors were identified from the pathology records of all Israeli hospitals and from Israeli national cancer and death registries. Doses of radiation to the neural tissue were retrospectively estimated for each patient (mean, 1.5 Gy). Sixty neural tumors developed in the patients exposed as children, and the 30-year cumulative risk (.+-.SE) was 0.8 .+-. 0.2 percent. The incidence of tumors was 1.8 per 10,000 persons per year. The estimated relative risk as compared with that for 10,834 matched general-population controls and 5392 siblings who had not been irradiated was 6.9 (95 percent confidence interval, 4.1 to 11.6) for all tumors and 8.4 (confidence interval, 4.8 to 14.8) when the analysis was restricted to neural tumors of the head and neck. Increased risks were apparent for meningiomass (relative risk, 9.5; n = 19), gliomas (relative risk, 2.6; n = 7), nerve-sheath tumors (relative risk, 18.8; n = 25), and other neural tumors (relative risk, 3.4; n = 9). A strong dose-response relation was found, with the relative risk approaching 20 after estimated doses of approximately 2.5 Gy. Our study confirms that radiation doses on the order of 1 to 2 Gy can significantly increase the risk of neural tumors.