Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study
Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study
复制标题
DOI：
10.1159/000506131
复制
发表时间：
2020-03
影响因子：
5.7
通讯作者：
E. Pasqual;G. Castaño‐Vinyals;I. Thierry-Chef;N. Kojimahara;M. Sim;M. Kundi;D. Krewski;F. Momoli;B. Lacour;T. Remen;K. Radon;T. Weinmann;E. Petridou;M. Moschovi;R. Dikshit;S. Sadetski;M. Maule;M. Farinotti;M. Ha;A. ’t Mannetje;J. Alguacil;N. Aragonés;R. Vermeulen;H. Kromhout;E. Cardis
中科院分区：
文献类型：
--
作者：
E. Pasqual;G. Castaño‐Vinyals;I. Thierry-Chef;N. Kojimahara;M. Sim;M. Kundi;D. Krewski;F. Momoli;B. Lacour;T. Remen;K. Radon;T. Weinmann;E. Petridou;M. Moschovi;R. Dikshit;S. Sadetski;M. Maule;M. Farinotti;M. Ha;A. ’t Mannetje;J. Alguacil;N. Aragonés;R. Vermeulen;H. Kromhout;E. Cardis
背景资料：我们在MOBI-kids研究中探索了出生前和出生后放射诊断程序的电离辐射（IR）与脑癌风险之间的关联。研究方法：MOBI-kids是一项国际（澳大利亚、奥地利、加拿大、法国、德国、希腊、印度、以色列、意大利、日本、韩国、新西兰、西班牙、荷兰）病例对照研究，包括899例10 - 24岁的脑肿瘤（645例神经上皮）病例和1，910例性别、年龄、国家匹配的对照。通过个人访谈收集医学放射学史。我们估计每个程序的脑IR剂量，按年龄和时间段建立查找表。使用距诊断日期2年和5年的滞后时间计算终生累积剂量。使用条件Logistic回归估计风险。神经系统、心理和遗传状况被评估为潜在混杂因素。主要分析集中在神经上皮肿瘤。结果：总体而言，剂量非常低，呈偏态分布（中位数0.02 mGy，最大值217 mGy）。产后暴露的OR通常低于1。基于极少数病例，出生后和出生前暴露的最高剂量类别的OR均增加：分别为1.63（95% CI 0.44 - 6.00）和1.55（0.57 - 4.23）。根据医疗条件调整后的风险估计值变化不大。结论：几乎没有证据表明儿童和青少年放射诊断程序的IR与脑肿瘤风险之间存在关联。虽然剂量很低，但我们的研究结果表明，与目前的证据一致，产前和生命早期接触的风险较高。
Background: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. Methods: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10–24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. Results: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44–6.00) and 1.55 (0.57–4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. Conclusions: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.