Malignancies in German Thorotrast Patients and Estimated Tissue Dose

Kaick, G. van; Lorenz, Doug; Muth, H.; Kaul, A.

doi:10.1097/00004032-197807000-00012

Cited by 40 publications

(7 citation statements)

References 2 publications

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“…Names and addresses of more than 5,000 patients who had been treated with Thorotrast for cerebral arteriography (about 70%) or arteriography of the upper and lower limbs (30%) were obtained from records of different hospitals in the formerly Federal Republic of Germany (van Kaick et al, 1984). In none of our patients Thorotrast was injected for the detection of liver diseases.…”

Section: Patients and Methods Of Examinationmentioning

confidence: 99%

Neoplastic Diseases Induced by Chronic Alpha-irradiation - Epidemiological, Biophysical and Clinical Results of the German Thorotrast Study**

Kaick

Wesch

Lührs

et al. 1991

JRR

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Radiation carcinogenesis/alpha-irradiation/Thorotrast/Th-232The intravascular injection of the formerly used contrast medium Thorotrast -a colloidal suspension of thoriumdioxide causes a chronic exposure to a-particles especially in the organs of the reticuloendothelial system. The German Thorotrast Study comprises 2326 Thorotrast patients and 1890 contemporary matched patients in the control group to be evaluated. 899 Thorotrast patients and 662 controls had clinical and biophysical follow-up examinations every two years since 1969. The recent most important results of the study are: A high excess rate of primary liver cancer (410/2) was observed beginning after the 15th year of exposure. 31% of the tumors are combined with cirrhosis and 6% with other neoplastic diseases. A clear (mean) dose rate effect relationship exists. The tumor frequency depends on the time of exposure or the cumulative dose to the liver respectively and not primarily on the age at injection. The lowest cumulative doses at 10 years before diagnosis of liver cancer were about 2 Gy. Risk estimates for liver cancer after 40 years of exposure are 500 malignant tumors per 104 person-Gy for men and 300 for women.A high excess rate exists also for leukaemias (excluding CLL) starting already 5 years after Thorotrast injection (39/4). The lowest cumulative doses to the red bone marrow at time of death were about 0.5 Gy. According to the present result, an excess rate can be expected for carcinomas of the extrahepatic bile ducts, pancreas, oesophagus, larynx, as well as Non-Hodgkin's lymphomas, bone sarcomas, plasmacytomas and mesotheliomas.

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Section: Patients and Methods Of Examinationmentioning

confidence: 99%

Neoplastic Diseases Induced by Chronic Alpha-irradiation - Epidemiological, Biophysical and Clinical Results of the German Thorotrast Study**

Kaick

Wesch

Lührs

et al. 1991

JRR

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“…A significant proportion of patients who received this radiographic contrast medium intravascularly developed severe degenerative liver disease and primary hepatic tumors (6,20,22,31). Hepatic hemangiosarcomas comprise a high percentage of these tumors (19).…”

Section: Introductionmentioning

confidence: 99%

“…Hepatic hemangiosarcomas comprise a high percentage of these tumors (19). Liver neoplasms associated with Thorotrast administration develop with long latent periods (20-35 yr) following a radiation doses to the liver from thorium estimated at 1.5-32 Gy (16,22,31).…”

Section: Introductionmentioning

confidence: 99%

Hepatic Neoplasms from Internally Deposited 144CeCl3

Hahn¹,

Muggenburg²,

Boecker³

1996

Toxicol Pathol

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Fifty-five dogs were exposed by inhalation to graded activity levels of 144 CeCl 3 , a relatively soluble form of the β-emitting radionuclide. A large portion of the 144 Ce translocated from lung to liver and skeleton. Significant radiation doses were delivered to the respiratory tract, liver, and skeleton; however, the liver received the greatest cumulative absorbed dose. Liver tumors were the most frequently observed neoplasms in these exposed dogs and included 7 primary hepatic hemangiosarcomas, 1 cholangiocarcinoma, 1 hepatocellular carcinoma, 1 fibrosarcoma, 4 biliary cystadenomas, and 1 fibroma. The dose to the liver in these dogs ranged from 11 to 250 Gy with a median of 57 Gy. Autoradiographs showed a relative uniform distribution of & b e t a ; dose to the liver. All the malignant tumors and 1 cystadenoma were primary causes of death. The morphologic features of the hemangiosarcomas and associated hepatic lesions were similar to those described for hemangiosarcomas induced in people exposed to Thorotrast. Biliary cystadenomas were associated with degenerative lesions in the liver but not with other neoplasms in the liver. These results indicate that the liver is an important target organ for effects from internally deposited 144 Ce.

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“…The average value for D ␣ was 7.2 Gy in our p-Pu-related group (persons with D ␣ Ͼ 2.0 Gy) with minimum and maximum values 2.9 and 16.9 Gy, respectively. For the Thorotrast-exposed cases, average values for D ␣ were 6.09 Gy (609 rad), 8.3 Gy (830 rad), and 9.2 Gy (920 rad) for the German, Danish, and Portuguese cohorts, respectively (Mole 1978;Kaul and Noffz 1978;van Kaick et al 1978); and 9.2 Gy (920 rad; Mori et al 1986) and 8.2 Gy (820 rad; Ishikawa et al 1993) for the Japanese cohort. The alpha-radiation dose distribution for the p-Purelated group and German Thorotrast cohorts (van Kaick et al 1978) were also similar.…”

Section: Figmentioning

confidence: 94%

Influence of Alpha and Gamma Radiations and Non-Radiation Risk Factors on the Incidence of Malignant Liver Tumors Among Mayak Pa Workers

Tokarskaya¹,

Zhuntova²,

Scott

et al. 2006

Health Physics

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This Mayak worker-based study focuses on evaluating possible associations between malignant liver cancers and chronic alpha irradiation, chronic gamma irradiation, and non-radiation risk factors (alcohol consumption, smoking, viral hepatitis, chemical exposure, and chronic digestive diseases). This is the first multivariate study related to liver cancer among Mayak workers. The study was performed using the nested, case-control approach and includes 44 cases of malignant liver tumors diagnosed from 1972 to 1999, and 111 matched controls. Adjusted odds ratio (OR(ad)) was evaluated relative to a group of workers with alpha radiation doses to liver (D(alpha)) < 2.0 Gy. Dose estimates of D(alpha) > 2.0 Gy (corresponding (239)Pu body burden estimates >20.4 kBq) were significantly associated (p < 0.003) with the occurrence of hemangiosarcomas (HAS) but only marginal significance (0.05 < p < 0.1) was found for hepatocellular cancers (HCC). The ORad for HAS was 41.7 [95% confidence interval (CI): 4.6, 333] for a group with D(alpha) in the range >2.0-5.0 Gy and was 62.5 (7.4, 500) for a group with D(alpha) > 5.0-16.9 Gy. The attributable risk (AR) was calculated as 82%. For HCC, O(Rad) was estimated as 8.4 (0.8, 85.3; p < 0.07) for a group with D(alpha) in the range >2.0-9.3 Gy. For the indicated group, the AR was 14%. An association with high external gamma-ray doses (D(gamma)) to the total body was revealed for both HCC and for combined liver cancers when dose was treated as a continuous variable. However, we find no evidence that chronic low doses of gamma rays are associated with liver cancer occurrence. Cholangiocarcinoma (CHC) was not associated with either alpha- or gamma-ray exposure. As expected, an association between alcohol abuse and HCC was inferred [O(Rad) = 3.3 (1.2, 9); AR = 41%] but not for CHC or HAS.

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Malignancies in German Thorotrast Patients and Estimated Tissue Dose

Cited by 40 publications

References 2 publications

Neoplastic Diseases Induced by Chronic Alpha-irradiation - Epidemiological, Biophysical and Clinical Results of the German Thorotrast Study**

Neoplastic Diseases Induced by Chronic Alpha-irradiation - Epidemiological, Biophysical and Clinical Results of the German Thorotrast Study**

Hepatic Neoplasms from Internally Deposited 144CeCl3

Influence of Alpha and Gamma Radiations and Non-Radiation Risk Factors on the Incidence of Malignant Liver Tumors Among Mayak Pa Workers

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