Radiation-Induced Skin Carcinomas of the Head and Neck

Abstract

Radiation exposures to the scalp during childhood for tinea capitis were associated with a fourfold increase in skin cancer, primarily basal cell carcinomas, and a threefold increase in benign skin tumors. Malignant melanoma, however, was not significantly elevated. Overall, 80 neoplasms were identified from an extensive search of the pathology logs of all major hospitals in Israel and computer linkage with the national cancer registry. Radiation dose to the scalp was computed for over 10,000 persons irradiated for ringworm (mean 7 Gy), and incidence rates were contrasted with those observed in 16,000 matched comparison subjects. The relative risk of radiogenic skin cancer did not differ significantly between men or women or by time since exposure; however, risk was greatest following exposures in early childhood. After adjusting for sex, ethnic origin, and attained age, the estimated excess relative risk was 0.7 per Gy and the average excess risk over the current follow-up was 0.31/10(4) PY-Gy. The risk per Gy of radiation-induced skin cancer was intermediate between the high risk found among whites and no risk found among blacks in a similar study conducted in New York City (Shore et al., Radiat. Res. 100, 192-204, 1984). This finding suggests the role that subsequent exposure to uv radiation likely plays in the expression of a potential radiation-induced skin malignancy.

Occupational ionising radiation and risk of basal cell carcinoma in US radiologic technologists (1983–2005)

“…Our observations of a greater BCC risk at younger exposure ages are supported by other studies, in particular in the Japanese atomic bomb survivors5 and in the two groups of patients treated with radiation for tinea capitis 3 9. More generally, there is abundant evidence of increased relative risk at younger exposure age for most types of radiation-related cancers 26 34 35.…”

“…The Japanese atomic bomb survivors reported an ERR/Sv=0.7 (95% CI 0.3 to 1.6), and the data suggest a possible threshold at 0.6 Gy 7. The Israeli tinea capitis cohort, exposed in childhood, had an ERR/Gy=0.7 (95% CI 0.3 to 1.4)3 and the New York tinea capitis cohort, also exposed in childhood, had an ERR/Gy=1.6 (95% CI 1.3 to 2.1) 9…”

“…The studies of Japanese atomic bomb survivors3 6 7 26 and data on radiotherapy patients3 9 10 27 28 have established an association between IR and BCC for doses of about 1 Gy, the former providing information on acute exposures and the latter on fractionated exposures. However, these studies are uninformative as to the relation between low dose chronic IR exposure and BCC risk 22.…”

“…A less common risk factor for BCC is exposure to moderate to high doses of ionising radiation (IR) 2–4. An association between IR and increased BCC risk has been reported in the atomic bomb survivors,5–7 and in patients irradiated for medical reasons 3 8–10. In these studies, dose was acute or high and fractionated.…”

Radiation Induced Sarcoma of Hypopharynx: A Case Report

“…Although radiation induced sarcoma is a well-recognized long term complication of radiation therapy for other sites, the head and neck are less commonly affected (7,8).…”