Physics Bucharest 2017

Position of RT induced 2 nd tumors relative to HIGH DOSE AREA

Various primary tumors:

 Prostate : increased risk relative to surgery, for  10 y fu: bladder (ERR=77%), rectum (105%), in-field sarcomas (217%), and lung (42%) (Brenner et al. 2000)

 Breast : compared to no RT: contralateral breast (ERR=18%), soft-tissue sarcoma (134%), lung (61%), oesophagus (106%), leukemia (71%) (EBCTCG, Lancet 2005)

 Breast : compared to no RT: ERR= 45% for sites with D>1Gy (lung, oesophagus, pleura, bone, soft tissue), ERR=9% for contralateral breast ca (D≈1Gy), no evidence for enhanced risk for D<1 Gy (Berrington de Gonzalez et al. 2010)

Clinical data

 Cervix : compared to general population: for all latency periods ERR(D>3Gy) > ERR(1Gy ERR(D<1Gy). 10-19y: 53%, 22%, 12% (Chaturvedi, Travis, et al, 2007)

 Several sites : 85%: D  3 Gy (Dörr and Herrmann, 2002)

Relatively few secondary solid cancers for very low doses

29