Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

Ruth A Kleinerman; Susan A Smith; Eric Holowaty; Per Hall; Eero Pukkala; Leila Vaalavirta; Marilyn Stovall; Rita Weathers; Ethel Gilbert; Berthe M P Aleman; Magnus Kaijser; Michael Andersson; Hans Storm; Heikki Joensuu; Charles F Lynch; Graça M Dores; Lois B Travis; Lindsay M Morton; Rochelle E Curtis

doi:10.1016/j.ijrobp.2013.04.010

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Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

Journal article

Peer reviewed

Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

Ruth A Kleinerman, Susan A Smith, Eric Holowaty, Per Hall, Eero Pukkala, Leila Vaalavirta, Marilyn Stovall, Rita Weathers, Ethel Gilbert, Berthe M P Aleman, …

International journal of radiation oncology, biology, physics, Vol.86(5), pp.922-929

08/01/2013

DOI: 10.1016/j.ijrobp.2013.04.010

PMCID: PMC3831516

PMID: 23707149

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Abstract

To assess the dose-response relationship for stomach cancer after radiation therapy for cervical cancer. We conducted a nested, matched case-control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3). More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥ 5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, Ptrend=.047) compared with nonirradiated women. A highly significant radiation dose-response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (Ptrend=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (Ptrend=.23). Our findings show for the first time a significant linear dose-response relationship for risk of stomach cancer in long-term survivors of cervical cancer.

Radiotherapy Dosage

Confidence Intervals

Uterine Cervical Neoplasms - radiotherapy

Humans

Middle Aged

Survivors

Risk

Stomach Neoplasms - pathology

Case-Control Studies

Registries - statistics & numerical data

Aged, 80 and over

Adult

Female

Aged

Neoplasms, Radiation-Induced - pathology

Odds Ratio

Stomach Neoplasms - etiology

Dose-Response Relationship, Radiation

Details

Title: Subtitle: Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer
Creators: Ruth A Kleinerman - Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Rockville, Maryland, USA. kleinerr@mail.nih.gov
Susan A Smith
Eric Holowaty
Per Hall
Eero Pukkala
Leila Vaalavirta
Marilyn Stovall
Rita Weathers
Ethel Gilbert
Berthe M P Aleman
Magnus Kaijser
Michael Andersson
Hans Storm
Heikki Joensuu
Charles F Lynch
Graça M Dores
Lois B Travis
Lindsay M Morton
Rochelle E Curtis
Resource Type: Journal article
Publication Details: International journal of radiation oncology, biology, physics, Vol.86(5), pp.922-929
DOI: 10.1016/j.ijrobp.2013.04.010
PMID: 23707149
PMCID: PMC3831516
NLM abbreviation: Int J Radiat Oncol Biol Phys
ISSN: 1879-355X
eISSN: 1879-355X
Publisher: Elsevier BV; United States
Grant note: Z99 CA999999 / Intramural NIH HHS N01-CP-31155 / NCI NIH HHS N01-CP-31156 / NCI NIH HHS N01-CP-31157 / NCI NIH HHS N01-CP-31003 / NCI NIH HHS
Language: English
Date published: 08/01/2013
Academic Unit: Epidemiology
Record Identifier: 9983995136102771

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