Radiation-induced cancer risk from annual computed tomography for patients with cystic fibrosis
Radiation-induced cancer risk from annual computed tomography for patients with cystic fibrosis
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DOI：
10.1164/rccm.200704-591oc
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发表时间：
2007-11-15
影响因子：
24.7
通讯作者：
Samet, Jonathan M.
中科院分区：
文献类型：
--
作者：
de Gonzalez, Amy Berrington;Kim, Kwang Pyo;Samet, Jonathan M.
基本原理。CT被认为是囊性纤维化症患者肺损伤的常规监测工具。然而，人们对辐射诱发癌症的相关风险提出了担忧。目的：假设从2岁开始进行年度监测，估计囊性纤维化患者肺CT辐射诱发癌症的风险。方法：使用辐射风险模型(主要来自日本原子弹幸存者的研究)来估计接受肺CT可测量剂量的器官辐射诱发癌症的超额风险。考虑了两种情况：中位生存期至36岁(接近当前的中位生存期)和中位生存期至50岁(预计到2030年的中位生存期)。测量和主要结果：假设中位生存期至36岁，男性每年的肺部CT估计辐射诱发癌症的风险为0.02%，女性为0.07%。假设中位生存期增加到50岁，男性的估计风险增加到0.08%，女性增加到0.46%。女性患放射性乳腺癌的风险较高(占总风险的50%)，患甲状腺癌的风险也较高。结论：囊性纤维化患者反复进行肺部CT扫描导致辐射致癌的累积风险相对较小(小于0.5%)。然而，在证明其益处将超过这些风险之前，不建议进行常规监测。
Rationale. Computed tomography (CT) is being considered as a tool for routine monitoring of lung damage in people with cystic fibrosis. Concern has been raised, however, about the associated risk of radiation-induced cancer. Objectives: To estimate the risk of radiation-induced cancer from lung CT for patients with cystic fibrosis, assuming annual monitoring starting at age 2 years.Methods: Radiation risk models (derived primarily from the study of Japanese atomic bomb survivors) were used to estimate the excess risk of radiation-induced cancer for the organs that receive measurable doses from lung CT. Two scenarios were considered: median survival to age 36 years (approximate current median survival) and median survival to age 50 years (projected median survival by 2030).Measurements and Main Results: The estimated risk of radiation-induced cancer from annual lung CT was 0.02% for males and 0.07% for females assuming median survival to age 36 years. The estimated risks increased to 0.08% for males and 0.46% for females assuming median survival increases to age 50 years. The risks are higher for females because of the risk of radiation-induced breast cancer (50% of total risk) and higher risk of thyroid cancer.Conclusions: The cumulative risk of radiation-induced cancer from repeated lung CT scans for patients with cystic fibrosis is relatively small (less than 0.5%). However, routine monitoring should not be recommended until there is a demonstrated benefit that will outweigh these risks.