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: 8565424
• 负责人: Amy Berrington
• 金额: $ 196.72万
• 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/8565424
• 关键词: Accounting; Age; Alkylating Agents; Benign; Bone Marrow Transplantation; Brachytherapy; Breast; Cancer Survivor; Cells; Cervix Uteri; Childhood Cancer Survivor Study; Chronic; Contralateral; Data; Databases; Diagnosis; Disease; Disease model; Dose; Esophagus; Etiology; Evaluation; External Beam Radiation Therapy; Feasibility Studies; Genes; Genetic; Gynecologic; Heart Diseases; Hematologic Neoplasms; Hematopoietic Neoplasms; Hodgkin Disease; Incidence; Individual; Intensity-Modulated Radiotherapy; International; Ionizing radiation; Japanese Population; Late Effects; Life Style; Localized Malignant Neoplasm; Malignant Childhood Neoplasm; Malignant Neoplasms; Malignant neoplasm of cervix uteri; Malignant neoplasm of esophagus; Malignant neoplasm of pancreas; Malignant neoplasm of testis; Malignant neoplasm of thyroid; Medical; Medicare; Methods; Modeling; Monitor; Monograph; Multiple Myeloma; Mutation; Neoplasms; Nested Case-Control Study; Non-Hodgkin' s Lymphoma; Outcome; Pancreas; Patients; Peptic Ulcer; Pharmaceutical Preparations; Population Study; Protons; Publications; Publishing; RB1 gene; Radiation; Radiation Interaction; Radiation therapy; Research Personnel; Resources; Retinoblastoma; Risk; Risk Factors; SEER Program; Salivary Glands; Second Primary Cancers; Skin; Solid Neoplasm; Statistical Models; Stomach; Survivors; Therapeutic; Thyroid Gland; Tissues; Uncertainty; Update; Woman; Work; bone; cancer risk; cancer therapy; chemotherapy; childhood cancer survivor; cohort; dosimetry; follow-up; gastrointestinal; genome wide association study; interest; internal radiation; leukemia; malignant breast neoplasm; malignant stomach neoplasm; mathematical model; melanoma; mortality; neoplasm registry; novel; response; soft tissue; tumor

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. In 2012 the first estimates of the proportion of second cancers related to radiotherapy were published. 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. Results were submitted for publication in 2012. Childhood Cancer Survivor Study - 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, salivary 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. New analyses of second breast cancers in relation to prior cancer treatment and potential effect modifiers has been initiated. The CCSS also 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 performing a genome wide association study of subsequent neoplasms within this cohort (10597). 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 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. Feasibility work in SEER-Medicare and local cancer registries is in progress. 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 as well as related dosimetry methods projects 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 Kaiser - 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. Studies of RB1 mutations and second cancer risks are in progress.

REB 研究人员使用监测流行病学和最终结果计划癌症登记数据库评估所有癌症之后罹患多种癌症的风险，该数据库包括 1973 年至 2008 年诊断的超过 200 万癌症幸存者。2006 年多原发专着中的有趣发现随后进行了个别研究评估与放射相关和化疗相关的第二种癌症的风险。特别感兴趣的研究包括乳腺癌、霍奇金淋巴瘤、非霍奇金淋巴瘤、视网膜母细胞瘤和儿童癌症的幸存者。 2012 年，首次发布了与放疗相关的第二种癌症比例的估计值。良性妇科疾病放射治疗后的癌症 - 正在更新近 15,000 名女性的个体放射剂量数据，以评估实体瘤和白血病风险。结果于 2012 年提交发表。 儿童癌症幸存者研究 - 在 14,000 名 5 年儿童癌症幸存者的队列中，我们对乳腺癌、甲状腺、唾液腺、骨、软组织的第二原发癌进行了巢式病例对照研究和皮肤来评估放疗和化疗与这些癌症风险之间的关系。一项新的发现是，甲状腺暴露于低于 20 Gy 辐射的患者中，甲状腺癌风险与之前接受烷化剂治疗有关。与既往癌症治疗和潜在效果调节剂相关的第二乳腺癌的新分析已经启动。 CCSS 还是检查基因辐射相互作用潜力的独特资源和难得机会。特别值得注意的是生物样本的可用性、有关放疗和化疗剂量的高质量信息以及队列暴露时的年轻年龄。我们目前正在对该队列中的后续肿瘤进行全基因组关联研究 (10597)。消化性溃疡患者的癌症风险 - 将 2000 名接受辐射的消化性溃疡患者与 2000 名未接受辐射的消化性溃疡患者进行比较，以细化所有癌症和心脏病的剂量相关风险，并对这些疾病的剂量估计的不确定性进行建模结果。质子和调强放射治疗有可能向肿瘤提供最大剂量，同时最大限度地减少可能导致第二种癌症的周围组织的剂量。 SEER-Medicare 和当地癌症登记处的可行性工作正在进行中。各种放射治疗照射组中造血系统恶性肿瘤的射频分析 - 使用各种数学和统计模型对日本原子弹幸存者和治疗照射组中与电离辐射暴露相关的癌症风险进行并行分析。终点包括所有血液系统癌症，特别是白血病（包括慢性淋巴细胞白血病（CLL））、霍奇金病、非霍奇金淋巴瘤（NHL）和多发性骨髓瘤。该模型考虑了由于内部和外部辐射暴露（包括近距离放射治疗）而导致的细胞再增殖和重新分布，以及暴露年龄和达到年龄等因素。放射剂量反应和第二原发性胃癌、食道癌和胰腺癌 - 一项针对第二原发性胃肠道癌（胃肠道胃癌、胰腺癌和食道癌）癌症的国际研究正在霍奇金淋巴瘤、睾丸癌、乳腺癌和宫颈癌的幸存者中进行癌症提供有关辐射剂量和随后的胃肠道癌症风险的新数据。迄今为止的研究结果表明，继乳腺癌之后，食道癌的风险增加与剂量相关。 HL、睾丸癌和宫颈癌后胃肠道恶性肿瘤风险的分析以及相关剂量测定方法项目正在进行中。队列联盟中第二种癌症的危险因素 - 正在评估 NCI 队列联盟中研究第二种癌症的可行性。凯撒乳腺癌之后的第二种癌症 - 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。我们正在探索在三个不同队列中研究对侧乳腺癌治疗和可改变生活方式危险因素的可行性。视网膜母细胞瘤之后的第二种癌症 - 继续监测 1,850 名视网膜母细胞瘤幸存者的队列，以了解与过去放疗和化疗相关的所有第二种原发癌症（主要是骨癌、软组织癌和黑色素瘤）的发病率和死亡率。 RB1 突变和第二种癌症风险的研究正在进行中。