小児期の最初の腫瘍後の一次性甲状腺がん (小児がん生存者研究):内蔵症例対照研究である

Alice J Sigurdson¹, Cécile M Ronckers, Ann C Mertens

¹Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7238, USA. sigurdsa@mail.nih.gov

Lancet (London, England)

|June 14, 2005

まとめ

頭,首,胸の放射線治療を受けた小児がんの生存者は,甲状腺がんのリスクが高まります. このリスクは,放射線量が30Gyに達すると上昇し,その後,おそらく細胞破壊効果のために減少します.

科学分野:

腫瘍学腫瘍学
放射線腫瘍学放射線腫瘍学
エピデミオロジーエピデミオロジー

背景:

頭部,首,または上部胸部に放射線治療を受けた小児がんの生存者は,その後の一次性甲状腺がんを発症するリスクが高くなります.
治療用放射線用量範囲におけるこのリスクの正確な大きさは,まだ完全に理解されていません.

研究の目的:

放射線治療と化学療法後の甲状腺がんの長期的なリスクを定量化するために,小児がんの生存者.
放射線被曝と甲状腺がんの発症の間の用量反応関係を調査する.

主な方法:

児童がん生存者研究コホートからのデータを用いて,内蔵された症例対照研究が行われました.
1970年から1986年の間に小児がんと診断された14,054人の5年生存者から69人の甲状腺がん症例と265人のマッチングコントロールが特定され,2000年まで追跡調査が行われました.

主要な成果:

20~29 Gy (OR 9.8) までの放射線用量で甲状腺癌のリスクが著しく増加した.
30 Gyを超える用量では,用量反応の減少が観察され,これは細胞破壊効果を示唆する可能性がある.
増加したリスクと減少したリスクの両方が,10歳以前に診断された個人により顕著でした. 化学療法は,甲状腺がんのリスクに影響したり,放射線療法の効果を変化させなかった.

結論:

30Gy以上の放射線用量で甲状腺癌のリスクが減少することが観察されたことから,細胞破壊効果があることが示唆される.
甲状腺がんの長期監視は,頭部,首,胸部に放射線治療を受けた小児がんの生存者,特にホジキンリンパ腫の病歴を有する者にとって極めて重要です.

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