Abstract no. 1017PURPOSE/OBJECTIVE(S): Ionizing radiation‐induced bone sarcomas have traditionally been associated with exposure to high levels of ionizing radiation. The role of exposure to lower levels of ionizing radiation in the development of such lesions remains speculative. Also, the appropriate dose‐response model of radiation dose exposure to excess relative risk (ERR) in association with bone sarcomas is questionable. MATERIALS/METHODS: The data source of the longitudinal, population‐based Life Span Study (N=120,321) cohort of atomic bomb survivors of Hiroshima and Nagasaki was utilized to estimate the ERR per Gray (Gy) of ionizing radiation exposure in the development of bone sarcomas. Other factors regarding sarcoma demographics …postprin

Cologne, J

Cullings, H

Funamoto, S

Hayashi, M

Kasagi, F

Kodama, K

Miles, EF

Nishi, N

Samartzis, D

Soda, M

Suyama, A

HKU Scholars Hub

Soft tissue sarcomas in atomic-bomb survivors of Hiroshima and Nagasaki

The 29th Annual Congress of the Hong Kong Orthopaedic Association (HKOA 2009), Hong Kong, 28-29 November 2009

Title Bone sarcomas in atomic bomb survivors of Hiroshima andNagasakiAuthor(s)Samartzis, D; Nishi, N; Hayashi, M; Cologne, J; Cullings, H;Kodama, K; Miles, EF; Funamoto, S; Suyama, A; Soda, M;Kasagi, FCitationThe 50th Annual Meeting of the American Society forTherapeutic Radiology and Oncology (ASTRO 2008), Boston,MA., 4-8 October 2008.Issued Date 2008URL http://hdl.handle.net/10722/62603Rights Creative Commons: Attribution 3.0 Hong Kong License  1017  Bone Sarcomas in Atomic Bomb Survivors of Hiroshima & Nagasaki D. Samartzis1, N. Nishi2, M. Hayashi2, Y. Shimizu2, J. Cologne2, H. Cullings2, K. Kodama2, E. F. Miles2, S. Funamoto2, A. Suyama2, et al., 1Shriners Hospital for Children, Chicago, IL, 2Radiation Effects Research Foundation, Hiroshima, Japan Purpose/Objective(s): Ionizing radiation‐induced bone sarcomas have traditionally been associated with exposure to high levels of ionizing radiation. The role of exposure to lower levels of ionizing radiation in the development of such lesions remains speculative. Also, the appropriate dose‐response model of radiation dose exposure to excess relative risk (ERR) in association with bone sarcomas is questionable. Materials/Methods: The data source of the longitudinal, population‐based Life Span Study (N=120,321) cohort of atomic bomb survivors of Hiroshima and Nagasaki was utilized to estimate the ERR per Gray (Gy) of ionizing radiation exposure in the development of bone sarcomas. Other factors regarding sarcoma demographics, age at time of exposure, time to diagnosis from exposure, survival, and additional clinical information were assessed. The follow‐up period of the study was from January 1, 1958 to December 31, 2001. Bone marrow dose in Gy units was utilized. Results: Following review, 80,181 participants met the inclusion criteria with a total of 2,170,679 person‐years at risk. Nineteen bone sarcomas were identified with an incidence rate of 0.9 per 100,000 person‐years. There were 11 males (58%) and 8 females (42%). The mean age at the time of the bombings was 32.4 years. Six participants (32%) were younger than 16 years of age at the time of the bombings. The mean age of sarcoma diagnosis was 61.6 years. The mean time to sarcoma diagnosis since exposure was 29.3 years. The mean bone marrow dose was 0.433 Gy. The most common sarcoma was classified as a malignant neoplasm with no further specification (42%), followed by osteosarcomas (26%). The most common cancer sites were bones of the pelvis, sacrum, and coccyx as well as associated joints (47%). The mean survival time after diagnosis was 2.5 years. Two participants were noted to be alive at final follow‐up. The overall five‐year survival rate unadjusted for treatment‐type was 25% (males, 45%; females, 0%). No association between radiation exposure to the time of diagnosis, morphology, or topography of the bone sarcoma could be discerned from this study. A linear model with a threshold at 0.85 Gy (95% CI: 0.12‐1.85) was found with an ERR of 1.1 at 1 Gy (8.7 at 2 Gy) (p=0.002). Conclusions: In contrast to the reported literature, our study suggests that the development of radiation‐induced bone sarcomas may be associated with exposure to much lower doses of ionizing radiation following a single whole body dose. A linear model with a threshold at 0.85 Gy was found to be the best predictive non‐hormetic model with a statistically significant ERR of 1.1 at 1 Gy (ERR=8.7 at 2 Gy). Due to the small sample size, the affects of age at the time of exposure and radiation dose could not be properly discerned with regards to bone sarcoma development. A poor clinical prognosis was associated with bone sarcomas. Author Disclosure:  D. Samartzis, None; N. Nishi, None; M. Hayashi, None; Y. Shimizu, None; J. Cologne, None; H. Cullings, None; K. Kodama, None; E.F. Miles, None; S. Funamoto, None; A. Suyama, None. 

Bone sarcomas in atomic bomb survivors of Hiroshima and Nagasaki

Podium Presentations. Podium No: 362Lower levels of ionizing radiation may be associated with the risk of radiation-induced soft tissue sarcomas. A linear dose-response model noted an ERR= 0.98 per Gy for soft tissue sarcomas. High levels of ionizing radiation have been associated with a risk of radiation-induced soft tissue sarcomas following therapeutic or occupational exposures. However, it remains relatively unknown whether the development of such lesions are associated with lower levels of radiation exposure. This study was a longitudinal, cohort-based analysis of the development of soft tissue sarcomas in 80,181 atomic bomb survivors of Hiroshima and Nagasaki followed from 1958 to 2001. Utilizing colon dose in Gray (Gy), the excess relative risk (ERR) per Gy of ionizing radiation absorbed dose was assessed. Various subject demographics, age-specificity, and survival parameters were also assessed. The study identified 105 soft tissue sarcomas (36 males, 69 females). The mean ages at the time of the bombings and diagnosis were 27.0 and 63.6 years, respectively. The mean colon dose was 18 cGy. The uterus and stomach were the most common organ-specific sites of sarcoma development. Leiomyosarcomas (35.2%) and malignant fibrous histiocytomas (10.5%) were the most prevalent sarcomas. An overall unadjusted 5-year survival rate of 42% was noted. A linear dose-response model fit the data well with an ERR of 0.98 per Gy (95% CI: 0.11-2.39; p=0.02). In contrast to the reported literature, this study is the first to suggest that lower levels of ionizing radiation may be associated with a risk of radiation-induced soft tissue sarcomas. A linear dose-response model produced an ERR of 0.98 per Gy for soft tissue sarcomas.The 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons, Las Vegas, Nevada, 26 February 2009

http://hub.hku.hk/bitstream/10722/62603/1/Abstract.pdf

Bone sarcomas in atomic bomb survivors of Hiroshima and Nagasaki

Abstract

Similar works

Full text

Available Versions

HKU Scholars Hub

HKU Scholars Hub

HKU Scholars Hub

HKU Scholars Hub

HKU Scholars Hub