Radiation and breast carcinogenesis
Radiation and breast carcinogenesis
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DOI：
10.1002/mpo.1122
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发表时间：
2001-05-01
期刊：
影响因子：
--
通讯作者：
Boice, JD
中科院分区：
文献类型：
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作者：
Boice, JD
除了辐射诱发的白血病可能是例外之外，对辐射诱发的乳腺癌的了解比任何恶性肿瘤都多[1,2]。十四项队列研究提供了世界各地不同人群服用不同剂量药物后风险水平的定量信息。加拿大、德国、日本、瑞典等北欧国家、英国和美国进行了综合研究（表一）。主要特征是剂量反应的线性（即直线充分拟合观察到的数据），以及暴露年龄的效应修正（即风险与暴露年龄成反比，超过绝经年龄的暴露似乎风险非常低）；以及分割剂量对后续风险的最小影响[3]。最近对来自 8 个队列的近 78,000 名女性和 1,500 名乳腺癌病例进行的综合分析证实，最高剂量水平下风险下降（部分与杀死细胞而不是转化有关），并且剂量分割对风险影响不大，至少在绝对范围内如此 [4]。目前尚不清楚易患癌症的人是否会因低剂量暴露而增加患放射诱发乳腺癌的风险，尽管这似乎不太可能[5]。关于儿童期接触高剂量后的影响的新数据将来自对儿童癌症幸存者的长期研究 (6-8)。医学。儿科。安科尔。 36:508-513, 2001。(C) 2001 Wiley-Liss, Inc.
With the possible exception of radiation-induced leukemia, more is known about radiation-induced breast cancer than any of her malignancy [1,2]. Fourteen cohort studies have provided quantitative information on the level of risk following a wide range of doses in different populations around the world. Comprehensive studies have been conducted in Canada, Germany, Japan, Sweden and other Nordic countries, the United Kingdom, and the USA (Table I). Key features are the linearity in the dose response (i.e., a straight line adequately fits the observed data), and the effect modification of age at exposure (i.e., risk is inversely related to exposure age and exposures past the menopausal ages appear to carry a very low risk); and the minimal effect of fractionating dose on subsequent risk [3]. A recent combined analysis of almost 78,000 women and 1,500 breast cancer cases from eight cohorts confirmed the downturn in risk at the highest dose levels (related in part to the killing of cells rather than transformation) and that fractionation of dose has little influence on risk, at least on an absolute scale [4]. It is not known whether persons predisposed to cancer are at enhanced risk of radiation-induced breast cancer from low-dose exposures, although this seems unlikely [5]. New data on the effects of high doses following childhood exposures will be forthcoming from long-term studies of the survivors of childhood cancer (6-8). Med. Pediatr. Oncol. 36:508-513, 2001. (C) 2001 Wiley-Liss, Inc.