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작성일 : 15-09-07 16:13
Risk of secondary cancers from scattered radiation during intensity-modulated radiotherapies for hepatocellular carcinoma
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조회 : 16,702  

Purpose: To evaluate and compare the risks of secondary cancers from therapeutic doses received by patients with
hepatocellular carcinoma (HCC) during intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT), and
tomotherapy (TOMO).
Methods: Treatments for five patients with hepatocellular carcinoma (HCC) were planned using IMRT, VMAT, and
TOMO. Based on the Biological Effects of Ionizing Radiation VII method, the excess relative risk (ERR), excess
absolute risk (EAR), and lifetime attributable risk (LAR) were evaluated from therapeutic doses, which were
measured using radiophotoluminescence glass dosimeters (RPLGDs) for each organ inside a humanoid phantom.
Results: The average organ equivalent doses (OEDs) of 5 patients were measured as 0.23, 1.18, 0.91, 0.95, 0.97, 0.24,
and 0.20 Gy for the thyroid, lung, stomach, liver, small intestine, prostate (or ovary), and rectum, respectively. From
the OED measurements, LAR incidence were calculated as 83, 46, 22, 30, 2 and 6 per 104 person for the lung,
stomach, normal liver, small intestine, prostate (or ovary), and rectum.
Conclusions: We estimated the secondary cancer risks at various organs for patients with HCC who received
different treatment modalities. We found that HCC treatment is associated with a high secondary cancer risk in the
lung and stomach.
Dong Wook Kim1, Kwangzoo Chung2, Weon Kuu Chung1, Sun Hyun Bae1, Dong Oh Shin3, Seongeon Hong3,
Sung Ho Park4, Sung-Yong Park5, Chae-Seon Hong2, Young Kyung Lim6, Dongho Shin6, Se Byeong Lee6,
Hyun-ho Lee7, Jiwon Sung7 and Myonggeun Yoon7*
1Department of Radiation Oncology, KyungHee University Hospital at
Gangdong, Seoul, Korea. 2Deparment of Radiation Oncology, Samsung
Medical Center, Seoul, Korea. 3Department of Radiation Oncology, KyungHee
University Medical Center, Seoul, Korea. 4Department of Neurosurgery, Ulsan
University Hospital, Ulsan, Korea. 5Proton Therapy Center, McLaren Cancer
Institute, Flint, USA. 6Proton Therapy Center, National Cancer Center, Ilsan,
Korea. 7Department of Radiological Science, College of Health Science, Korea
University, Jeongneung 3-dong, Seongbuk-gu, Seoul, Korea.
Kim et al. Radiation Oncology 2014, 9:109