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Cancer following radiotherapy for peptic ulcer
M L Griem1, R A Kleinerman, J D Boice
1Department of Radiation Oncology, University of Chicago, Ill 60637.
Journal of the National Cancer Institute
|June 1, 1994
Summary
Peptic ulcer patients treated with radiotherapy face increased cancer risks, particularly stomach cancer, even decades after treatment. Combined radiotherapy and surgery significantly elevate stomach cancer risk, underscoring long-term health surveillance needs.
Area of Science:
- Oncology
- Radiology
- Epidemiology
Background:
- Radiotherapy was historically used for peptic ulcers (1937-1965) with a mean dose of 14.8 Gy to reduce gastric acid.
- Patients treated for peptic ulcers often survive for many years, necessitating investigation into long-term health effects.
Purpose of the Study:
- To determine the risk of cancer-related mortality in patients who received radiotherapy for peptic ulcers.
Main Methods:
- A mortality study involved 3609 peptic ulcer patients (1831 irradiated, 1778 non-irradiated).
- Extensive patient tracing and reconstruction of radiation doses to organs were performed using original radiotherapy records.
Main Results:
- Overall cancer mortality was significantly increased in both irradiated and non-irradiated peptic ulcer patients compared to the general population.
- Radiotherapy was associated with significantly elevated relative risks (RR) for all cancers combined (RR=1.53), stomach cancer (RR=2.77), pancreatic cancer (RR=1.87), lung cancer (RR=1.70), and leukemia (RR=3.28).
- Combined radiotherapy and surgery, especially for gastric ulcers, appeared to increase stomach cancer risk up to tenfold.
Conclusions:
- Peptic ulcer patients face elevated cancer mortality risks due to factors including lifestyle and treatment.
- Radiotherapy, particularly when combined with surgery, significantly enhances the risk of developing stomach cancer.
- Long-term cancer risks persist for up to 50 years post-treatment, indicating lasting radiation effects.