Studies of Populations Exposed to Therapeutic Medical Radiation and Other Agents

暴露于治疗性医学辐射和其他药物的人群的研究

• 批准号: 8349562
• 负责人: Amy Berrington
• 金额: $ 297.39万
• 依托单位: DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8349562
• 关键词: Accounting; Adult; Adult Glioma; Age; Alkylating Agents; Autoimmune Diseases; Benign; Bone Marrow Transplantation; Brachytherapy; Brain; Brain Neoplasms; Breast; Cancer Survivor; Case-Control Studies; Cells; Cervical; Cervix Uteri; Child; Childhood Cancer Survivor Study; Chronic; Cohort Studies; Contralateral; Data; Databases; Death Rate; Diagnosis; Diagnostic; Disease; Disease model; Dose; Epidemiology; Esophagus; Etiology; Evaluation; Exposure to; External Beam Radiation Therapy; Feasibility Studies; Female; Fluoroscopy; General Population; Genes; Genetic; Gland; Glioma; Growth Factor; Gynecologic; Heart Diseases; Hematologic Neoplasms; Hematopoietic Neoplasms; Hodgkin Disease; Hypersensitivity; Immune; Immunity; Incidence; Individual; Intensity-Modulated Radiotherapy; International; Ionizing radiation; Japanese Population; Late Effects; Life Style; Liver; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Malignant neoplasm of esophagus; Malignant neoplasm of lung; Malignant neoplasm of pancreas; Malignant neoplasm of testis; Malignant neoplasm of thyroid; Medical; Military Personnel; Modeling; Molecular; Monitor; Monograph; Multiple Myeloma; Nested Case-Control Study; Non-Hodgkin' s Lymphoma; Outcome; Pancreas; Patient Monitoring; Patients; Peptic Ulcer; Pharmaceutical Preparations; Physicians; Population; Population Study; Procedures; Protons; Radiation; Radiation Interaction; Radiation therapy; Radiation-Induced Cancer; Recording of previous events; Research Personnel; Resources; Retinoblastoma; Risk; Risk Estimate; Risk Factors; Roentgen Rays; SEER Program; Saliva; Sampling; Second Primary Cancers; Serum; Serum Markers; Skin; Solid Neoplasm; Statistical Models; Stomach; Survivors; System; Technology; Therapeutic; Thyroid Gland; Tissues; Uncertainty; Update; Woman; Work; X-Ray Computed Tomography; bone; cancer risk; cancer therapy; chemotherapy; childhood cancer survivor; cohort; comparison group; cytokine; follow-up; gastrointestinal; genome wide association study; interest; internal radiation; leukemia; malignant breast neoplasm; malignant stomach neoplasm; mathematical model; melanoma; mortality; neoplasm registry; novel; radiologist; response; scoliosis; soft tissue; tumor

Interventional Fluoroscopy Fluoroscopically-guided radiation procedures can result in high radiation exposure to both the physician and patient. A cohort of physicians who perform interventional radiation procedures, radiologists and a comparison group has been assembled to estimate the risk of dying from cancer especially brain and leukemia. Analyses are in progress. Multiple Primary Systems REB investigators evaluate the risks of multiple cancers following all cancers using the Surveillance Epidemiology and End Results Program cancer registry database including more than 2 million cancer survivors diagnosed from 1973 to 2008. Interesting findings from the 2006 Multiple Primary Monograph have been followed up with individual studies evaluating risk of radiation-related and chemotherapy-related second cancers. Particular studies of interest include of survivors of breast cancer, Hodgkin lymphoma, non-Hodgkin lymphoma, retinoblastoma, and childhood cancers. Pilot Work for Genome-wide Association Study of Second Cancers Following Childhood Cancer The Childhood Cancer Survivor Study is a unique resource and a rare opportunity in which to examine the potential for gene-radiation interaction. Particularly noteworthy are the availability of biospecimens, high quality information on doses of radiation and chemotherapy, and the young age at exposure of the cohort. We are currently evaluating the possibility of performing a genome wide association scan for second cancers within this cohort. Breast and Other Cancers Following X-Rays for Scoliosis A multi-center retrospective cohort study of female scoliosis patients monitored with diagnostic x-rays, found a statistically significant 70% excess in breast cancer mortality compared to the general population. Risk increased significantly with increasing radiation dose to the breast. Death rates from other cancers (lung, cervical, liver) were lower than expected. A similar relationship was observed for breast cancer incidence. Cancer Following Radiotherapy for Benign Gynecologic Disorders Cancer mortality following radiation treatment for benign gynecologic conditions in a cohort of nearly 15,000 women with individual radiation dose data is being updated to evaluate solid tumor and leukemia risk. Childhood Cancer Survivor Study (CCSS) In a cohort of 14,000 5-year survivors of childhood cancer we performed nested case-control studies of second primary cancers of the breast, thyroid gland, Saliva/Buccal Cellsry gland, bone, soft tissue and skin to evaluate the relationship between radiation and chemotherapy and risk of these cancers. A novel finding was that thyroid cancer risk was related to prior treatment with alkylating agents among patients exposed to radiation less than 20 Gy to the thyroid. Cancer Risk in Peptic Ulcer Patients A of cohort of 2000 irradiated peptic ulcer patients is being compared to 2000 non-irradiated peptic ulcer patients to refine the dose-related risk for all cancers and cardiac disease and model the uncertainty in the dose estimates for these outcomes. Proton IMRT Proton and intensity-modulated radiation therapy have the potential to deliver maximal doses to the tumor while minimizing dose to the surrounding tissues which may cause second cancers. An international feasibility study to evaluate the risk of second cancers from this treatment has been initiated. RF Analysis of Hematopoietic Malignancies in Various Radiotherapeutically Irradiated Cohorts Parallel analysis using a variety of mathematical and statistical models of cancer risks associated with ionizing radiation exposure in the Japanese atomic bomb survivors and in therapeutically irradiated groups. Endpoints include all hematologic cancers, specifically leukemia (including chronic lymphocytc leukemia (CLL)), Hodgkins disease, non-Hodgkins lymphoma (NHL), and multiple myeloma. The models take account of cell repopulation and redistribution as a result of internal and external radiation exposure (including brachytherapy), and also factors such as age at exposure and attained age. Radiation Dose-Response and Second Primary Cancers of Stomach, Esophagus, and Pancreas An international study of second primary gastrointestinal (GI stomach cancer, pancreatic cancer, and esophageal cancer) cancers is being conducted among survivors of Hodgkin lymphoma testis cancer, breast and cervical cancer to provide new data on radiation dose and subsequent risk of GI cancer. Findings to date have demonstrated a dose-related increased risk of esophageal cancer following breast cancer. Analyses of GI malignancy risk after HL and testis and cervical cancers are in progress. Risk Factors for Second Cancers in the Cohort Consortium The feasibility of studying second cancers in the NCI Cohort Consortium is being assessed. Second Cancers after Breast Cancer in three Cohorts (Kaiser, Million women study and AARP) The etiology of contralateral breast is probably related to treatment, genetic and lifestyle risk factors. We are exploring the feasibility of studying treatment and modifiable lifestyle risk factors for contralateral breast cancer in three different cohorts. Second Cancers Following Retinoblastoma A cohort of 1,850 Retinoblastoma survivors continues to be monitored for the incidence and mortality of all second primary cancers, primarily of the bone, soft tissue, and melanoma in relation to past radiotherapy and chemotherapy. risk factors for contralateral breast cancer in three different cohorts. Second Cancers Following Retinoblastoma A cohort of 1,850 Retinoblastoma survivors continues to be monitored for the incidence and mortality of all second primary cancers, primarily of the bone, soft tissue, and melanoma in relation to past radiotherapy and chemotherapy. tiology of contralateral breast is probably related to treatment, genetic and lifestyle risk factors. We are exploring the feasibility of studying treatment and modifiable lifestyle risk factors for contralateral breast cancer in three different cohorts. Secondary Cancers of the Brain, Breast, and Thyroid among Childhood Cancer Survivors In a cohort of 14,000 5-year survivors of childhood cancer we performed nested case-control studies of second primary cancers of the breast, thyroid gland, Saliva/Buccal Cellsry gland, bone, soft tissue and skin to evaluate the relationship between radiation and chemotherapy and risk of these cancers. A novel finding was that thyroid cancer risk was related to prior treatment with alkylating agents among patients exposed to radiation less than 20 Gy to the thyroid. Serum Markers of immunity and Risk of Brain Tumors Evidence that a history of allergy and/or autoimmune diseases is associated with a reduced risk of gliomas in adults will be followed up in a case-control study of adult gliomas nested within 7 million U.S. military personnel with pre-diagnostic serum samples. We will quantify the dose-response relationship between risk of gliomas and levels of selected cytokines/growth factors and immune-related disorders in the subjects.

介入透视透视透视引导的放射程序可能会导致医生和患者的高辐射暴露。已经组装了一批进行介入放射程序，放射科医生和比较组的医生，以估计死于癌症，尤其是大脑和白血病的风险。分析正在进行中。多个主要系统REB调查人员使用监视流行病学和最终结果癌症注册表数据库评估了多种癌症的风险，包括1973年至2008年诊断出的2000多个癌症幸存者。2006年的有趣发现。对2006年的多个主要专着的发现，对评估放射降低和化学治疗疗法和化学治疗的个人研究进行了调查。感兴趣的特定研究包括乳腺癌幸存者，霍奇金淋巴瘤，非霍奇金淋巴瘤，视网膜母细胞瘤和儿童期癌症。儿童癌后，儿童癌症幸存者研究是一种独特的资源，是一个难得的机会，可以在其中研究基因辐射相互作用的潜力。特别值得注意的是生物测量的可用性，有关放射剂量和化学疗法的高质量信息以及队列暴露时的年轻年龄。我们目前正在评估在该队列中对第二次癌症进行基因组范围扫描的可能性。 X射线脊柱侧弯后的乳腺癌和其他癌症是对诊断X射线监测的女性脊柱侧弯患者的多中心回顾性队列研究，发现与普通人群相比，乳腺癌死亡率统计学意义显着70％。随着乳房辐射剂量增加，风险显着增加。其他癌症（肺，宫颈，肝脏）的死亡率低于预期。观察到类似的乳腺癌发生率。放疗后，放疗后良性妇科疾病后，正在更新一个近15,000名具有个别放射剂量数据的女性的良性妇科疾病的良性治疗后的癌症死亡率，以评估实体瘤和白血病风险。儿童癌症幸存者研究（CCSS）在14,000名5年儿童癌症的共生中，我们对乳腺，甲状腺，甲状腺/颊细胞腺体/颊细胞腺，骨，软组织和皮肤的第二个原发性癌进行了嵌套的病例对照研究，以评估这些放射疗法和化学疗法和风险之间的关系。一个新的发现是，甲状腺癌的风险与暴露于甲状腺小于20 Gy的患者中的烷基化剂先前治疗有关。将2000名辐照消化性溃疡患者队列的消化性溃疡患者a与2000名未染色的消化性溃疡患者进行了比较，以优化所有癌症和心脏病的剂量相关风险，并模拟这些癌症的不确定性的不确定性。质子IMRT质子和强度调节的放射治疗具有将最大剂量输送到肿瘤的潜力，同时最大程度地减少可能导致第二癌的周围组织的剂量。已经开始了一项国际可行性研究，以评估这种治疗方法的第二癌风险。在各种放射性辐照的人群中对造血恶性肿瘤进行的RF分析，使用了与日本原子弹幸存者和治疗辐照组中的各种数学和统计模型相关的癌症风险的数学和统计模型。终点包括所有血液癌，特别是白血病（包括慢性淋巴细胞性白血病（CLL）），霍奇金斯疾病，非霍奇金斯淋巴瘤（NHL）和多发性骨髓瘤。这些模型考虑了由于内部和外部辐射暴露（包括近距离放射疗法）的结果，并考虑了细胞的重新分布，还考虑了诸如暴露年龄和达到年龄的因素。辐射剂量反应和胃，食道和胰腺的第二个原发性癌症是对第二胃肠道（胃肠道胃癌，胰腺癌和食道癌）癌的国际研究，正在hodgkin淋巴瘤睾丸癌，乳腺癌，乳腺癌，乳腺癌，乳腺癌，癌症和宫颈癌的癌症中进行癌症的癌症，从而提供癌症的疾病癌症，并提供新的疾病癌症。迄今为止的发现表明，乳腺癌后剂量相关的食管癌风险增加。 HL和睾丸和宫颈癌后的GI恶性风险的分析正在进行中。在队列联盟中第二癌的危险因素正在评估NCI队列联盟中第二次癌症的可行性。乳腺癌后三个队列（Kaiser，百万妇女研究和AARP）的第二癌对侧乳房的病因可能与治疗，遗传和生活方式危险因素有关。我们正在探索研究治疗和可修改的生活方式危险因素的可行性，以在三种不同的同伴中对侧乳腺癌。视网膜细胞瘤之后的第二癌，1,850个视网膜母细胞瘤幸存者的队列继续受到监测的所有第二次主要癌症的发病率和死亡率，主要是骨骼，软组织和黑色素瘤与过去的放疗和化学疗法有关。三种不同队列中对侧乳腺癌的危险因素。视网膜细胞瘤之后的第二癌，1,850个视网膜母细胞瘤幸存者的队列继续受到监测的所有第二次主要癌症的发病率和死亡率，主要是骨骼，软组织和黑色素瘤与过去的放疗和化学疗法有关。对侧乳房的tiology可能与治疗，遗传和生活方式危险因素有关。我们正在探索研究治疗和可修改的生活方式危险因素的可行性，以在三种不同的同伴中对侧乳腺癌。儿童癌症幸存者中的大脑，乳房和甲状腺的次要癌症在14,000个5年的儿童癌症中，我们对乳腺癌的第二个主要癌症，甲状腺，唾液腺，唾液/肿瘤细胞，骨骼，骨骼，软组织和皮肤的关系和化学的关系和化学的关系和化学的关系和化学疗法和这些癌症的关系和这些癌症的关系和这些癌症的关系和这些癌症的关系和这些癌症的关系和这些驱动器之间的关系进行了嵌套的病例对照研究。一个新的发现是，甲状腺癌的风险与暴露于甲状腺小于20 Gy的患者中的烷基化剂先前治疗有关。血清免疫和脑肿瘤风险的血清标记证据表明，在成年人的病例对照研究中，将跟踪成人神经膜瘤的风险降低的成人神经膜瘤的风险降低的成人神经胶质瘤，该研究将在700万美国军事人员使用前诊断血清样本的情况下进行。我们将量化神经胶质瘤风险与选定的细胞因子/生长因子的水平和受试者免疫相关疾病之间的剂量反应关系。