Radiation induced secondary malignancies: a review article

Abstract

Radiation-induced second malignancies (RISM) is one of the important late side effects of radiation therapy and has an impact on optimal treatment decision-making. Many factors contribute to the development of RISM such as age at radiation, dose and volume of irradiated area, type of irradiated organ and tissue, radiation technique and individual and family history of cancer. Exact mechanism of RISM is unknown. But nowadays, it is a growing concern in oncology because of the increased number of cancer survivors and efforts are being made to prevent or decrease the incidence of RISM. The primary search for articles was carried via Google Scholar and PubMed with keywords included ‘radiation induced malignancies, second malignancies, and chemotherapy induced malignancies’. Additional papers were found through references from relevant articles. In this review article, we have discussed about the pathogenesis, factors contributing to RISM, screening and prevention strategies of RISM.

Heart‐sparing radiotherapy with three‐dimensional printing technology after mastectomy for patients with left breast cancer

“…Of these techniques, IMRT is a relatively new technique with the benefit of uniform dose distribution . However, it has the disadvantage of a larger low‐dose area, which has the possibility of increasing the risk of contralateral breast cancer or a secondary cancer . Another technique proposed to protect OAR is proton therapy.…”

“…6 However, it has the disadvantage of a larger low-dose area, which has the possibility of increasing the risk of contralateral breast cancer or a secondary cancer. 7 Another technique proposed to protect OAR is proton therapy. However, the number of clinics with proton therapy is limited and its current costeffectiveness has been reported to be inappropriate for use in breast cancer patients.…”

Effect of dose constraint on the thyroid gland during locoregional intensity‐modulated radiotherapy in breast cancer patients

“…One of the important challenges to address during breast RT is secondary cancer risk. Various reports have shown that increased low doses may increase the risk of secondary malignancy development . The move from three‐dimensional conformal RT to intensity‐modulated techniques involves more fields, and the dose‐volume histograms show that, as a consequence, a larger volume of normal tissue is exposed to lower doses.…”

BCL-XL is essential for the protection from secondary anemia caused by radiation-induced fatal kidney damage

“…However, TBI can also cause severe long-term damage to several organs, such as the lung, trachea and mouth (radiation-induced pneumonitis, fibrosis, oral mucositis) (Marks et al, 2003;Mehta, 2005), reproductive system (radiation-induced infertility) (Ogilvy-Stuart and Shalet, 1993), liver (radiation-induced liver disease) (Kim and Jung, 2017), gastro-intestinal tract (radiation-induced gastric mucositis, radiation-induced gastro intestinal syndrome) (Francois et al, 2013;Olcina and Giaccia, 2016) or kidney (radiation-induced nephropathy) (Cohen, 2000;Cohen and Robbins, 2003). Furthermore, TBI can also initiate secondary malignancies (Dracham et al, 2018).…”