Assessment of a carcinogenic risk for treatment of Graves’ ophthalmopathy in dependence on age and irradiation geometry

Broerse, J.J.; Snijders-Keilholz, A.; Jansen, Jan; Zoetelief, J.; Klein, Claudia; Seegenschmiedt, M. H.

doi:10.1016/s0167-8140(99)00118-8

Cited by 44 publications

(21 citation statements)

References 11 publications

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“…Johansson et al reported that the mean absorbed dose in red marrow is estimated at zero for patients in whom only distal parts of extremities were irradiated [18]. It may be useful to recall the epidemiological evidence that the attributable carcinogenic lifetime risk is considerably smaller at older age than earlier in life [5,8]. The applied gonad dose during the treatment of heel spurs is comparable to that of diagnostic imaging [13].…”

Section: Discussionmentioning

confidence: 99%

Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs – a retrospective multicenter study of 502 patients

et al. 2007

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Section: Discussionmentioning

confidence: 99%

Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs – a retrospective multicenter study of 502 patients

et al. 2007

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“…This is highlighted by the fact that some of these tumours occur with increasing frequency at nonirradiated sites and are therefore due to factors unrelated to treatment-possibly genetic pre-disposition [10]. After treatment for benign disease such as Grave's ophthalmopathy in young patients, an absolute lifetime risk of radiation-induced cancer has been estimated at 0.3% [3]. After treatment for joint disease at the knee or ankle in an adult, the only organ for which there is a quantifiable risk of second malignancy is skin, and the estimated absolute lifetime risk is 22×10 −8 per Gy [11].…”

Section: Discussionmentioning

confidence: 99%

Diffuse pigmented villonodular synovitis of the foot and ankle treated with surgery and radiotherapy

Lee

Mahroof

Pringle

et al. 2005

International Orthopaedics (SICO

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We followed up seven patients with histologically confirmed diffuse pigmented villonodular synovitis in a prospective study between 1992 and 2001. The mean age at diagnosis was 30.7 years. The patients underwent synovectomy, followed by radiotherapy with a total dose of 35 Gy in 20 fractions. In all cases, the excision was considered incomplete when examined histologically. At an average follow up of 24 (18-36) months, six patients reported better function and reduced levels of pain. One patient remained symptomatic but did not have a recurrence. We conclude that a combined approach to a primary pigmented villonodular synovitis of the foot and ankle may reduce the risk of recurrence without functional impairment.Résumé Nous avons suivi sept malades avec une synovite villonodulaire pigmentée diffuse confirmé histologiquement dans une étude prospective entre 1992 et 2001. L'âge moyen au diagnostic était de 30,7 ans. Les malades ont subi une synovectomie suivie d'une radiothérapie avec une dose totale de 35 Gy en 20 fractions. Dans tous les cas, la résection a été considérée incomplète à l'examen histologique. À une moyenne de suivi de 24 (18-36) mois, six malades ont une meilleure fonction et un niveau réduit de douleur. Un malade est resté symptomatique, mais sans récidive. Nous concluons qu'un traitement combiné d'une synovite villonodulaire pigmenté du pied et de la cheville peut réduire le risque de récidive sans dégrada-tion fonctionnelle.

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“…Due to our planning systems, technically, bone marrow volume in the irradiation volume could not be measured, but Broerse et al [12] and the ICRP [13], assuming approximate values of 7-8% of total bone marrow in the head, calculated an amount of about 2% bone marrow in the field based on an equal distribution of bone marrow in the skull. However, in an isotope investigation in the head Alavi et al [14] found that distribution was not uniform at all.…”

Section: Discussionmentioning

confidence: 99%

“…Broerse et al [12] assessed the carcinogenic risk due to the treatment of Graves' ophthalmopathy in dependence on age and irradiation geometry. They calculated the risk for induction of fatal malignancy to be 0.3-0.7%, and the risk for tumor induction to be 0.6-1.4% after 20 Gy (10 fractions !…”

Section: Discussionmentioning

confidence: 99%

The Risk of Radiation-Induced Carcinogenesis after External Beam Radiotherapy of Graves’ Orbitopathy

et al. 2003

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Purpose: In order to estimate the risk of radiation-induced carcinogenesis after external beam radiotherapy of Graves’ orbitopathy, we made dosimetric measurements with thermoluminescent dosimeters in a male Rando phantom using our treatment technique. Methods: We produced dose-volume histograms from 5-mm CT slices using our treatment planning system. In this way we estimated the irradiation dose received by the main surrounding organs such as the brain, the bone and the eyeball. We use 6-MV X-ray for the treatment of Graves’ orbitopathy and our total dose is 2,000 cGy, 200 cGy per fraction. Clinical target volume was limited to the retrobulbar orbital content and medial rectus muscle, sparing the lenses, lacrimal glands and the sella turcica. All dosimetric measurements with thermoluminescent dosimeters were made 3 times. Results: We found that the dose to the right lens was 101.6 mGy and to left lens 103.4 mGy. Average absorbed doses to red bone marow, thyroid, lung, esophagus, bone surface, skin and brain, respectively, were estimated to be 523, 21, 4, 5, 81, 29, 47 mGy. Then, using tissue weighting factors specified by the International Commission of Radiation Protection, the resulting total effective dose was calculated to be 66.8 mSv. Conclusion: The risk factor for fatal cancer development derived from human epidemiological data is presently assumed to be 10% per Gy. In patients treated by our method of retro-orbital external beam radiotherapy for Graves’ orbitopathy, there is a 0.0067 (or 7 per 1,000 persons or 0.7%) risk of developing fatal radiation-induced cancer.

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Assessment of a carcinogenic risk for treatment of Graves’ ophthalmopathy in dependence on age and irradiation geometry

Cited by 44 publications

References 11 publications

Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs – a retrospective multicenter study of 502 patients

Demographic, clinical and treatment related predictors for event-free probability following low-dose radiotherapy for painful heel spurs – a retrospective multicenter study of 502 patients

Diffuse pigmented villonodular synovitis of the foot and ankle treated with surgery and radiotherapy

The Risk of Radiation-Induced Carcinogenesis after External Beam Radiotherapy of Graves’ Orbitopathy

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