ArticleMedical physics2015
Assessment of uncertainties in radiation-induced cancer risk predictions at clinically relevant doses.
Article in Medical physics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Space Radiation and Cancer Risk in Astronauts: Models, Evidence, Uncertainties, and Emerging Imaging Perspectives.Tomography (Ann Arbor, Mich.) · 2026Review
- Secondary cancer risk from modern external-beam radiotherapy of prostate cancer patients: Impact of fractionation and dose distribution.Journal of radiation research · 2021Article
- Comparing second cancer risk for multiple radiotherapy modalities in survivors of hodgkin lymphoma.The British journal of radiology · 2021Article
- Proton Radiotherapy to Reduce Late Complications in Childhood Head and Neck Cancers.International journal of particle therapy · 2021Article
- Proton Radiotherapy Could Reduce the Risk of Fatal Second Cancers for Children with Intracranial Tumors in Low- and Middle-Income Countries.International journal of particle therapy · 2021Article
- The risk for developing a secondary cancer after breast radiation therapy: Comparison of photon and proton techniques.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2020Article
- Low- and middle-income countries can reduce risks of subsequent neoplasms by referring pediatric craniospinal cases to centralized proton treatment centers.Biomedical physics & engineering express · 2018Article
- Agreement between gamma passing rates using computed tomography in radiotherapy and secondary cancer risk prediction from more advanced dose calculated models.Quantitative imaging in medicine and surgery · 2017Article
- The effect of radiation therapy in the treatment of adult soft tissue sarcomas of the extremities: a long-term community-based cancer center experience.Cancer medicine · 2017Article
- Improving Head and Neck Cancer Treatments Using Dynamic Collimation in Spot Scanning Proton Therapy.International journal of particle therapy · 2016Article
- Profound and Sexually Dimorphic Effects of Clinically-Relevant Low Dose Scatter Irradiation on the Brain and Behavior.Frontiers in behavioral neuroscience · 2016Article
- A Review of Radiotherapy-Induced Late Effects Research after Advanced Technology Treatments.Frontiers in oncology · 2016Review
- The Impact of Neutrons in Clinical Proton Therapy.Frontiers in oncology · 2015Review
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
purposeTheoretical dose-response models offer the possibility to assess second cancer induction risks after external beam therapy. The parameters used in these models are determined with limited data from epidemiological studies. Risk estimations are thus associated with considerable uncertainties. This study aims at illustrating uncertainties when predicting the risk for organ-specific second cancers in the primary radiation field illustrated by choosing selected treatment plans for brain cancer patients.
methodsA widely used risk model was considered in this study. The uncertainties of the model parameters were estimated with reported data of second cancer incidences for various organs. Standard error propagation was then subsequently applied to assess the uncertainty in the risk model. Next, second cancer risks of five pediatric patients treated for cancer in the head and neck regions were calculated. For each case, treatment plans for proton and photon therapy were designed to estimate the uncertainties (a) in the lifetime attributable risk (LAR) for a given treatment modality and (b) when comparing risks of two different treatment modalities.
resultsUncertainties in excess of 100% of the risk were found for almost all organs considered. When applied to treatment plans, the calculated LAR values have uncertainties of the same magnitude. A comparison between cancer risks of different treatment modalities, however, does allow statistically significant conclusions. In the studied cases, the patient averaged LAR ratio of proton and photon treatments was 0.35, 0.56, and 0.59 for brain carcinoma, brain sarcoma, and bone sarcoma, respectively. Their corresponding uncertainties were estimated to be potentially below 5%, depending on uncertainties in dosimetry.
conclusionsThe uncertainty in the dose-response curve in cancer risk models makes it currently impractical to predict the risk for an individual external beam treatment. On the other hand, the ratio of absolute risks between two modalities is less sensitive to the uncertainties in the risk model and can provide statistically significant estimates.
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