The NCRP expert committee reviewed associations between radiotherapy and late adverse effects, concluding that older technologies remain relevant for current risk assessment when dose is considered.
What are the associations between radiotherapy and the risk of second malignant neoplasms and cardiovascular disease in cancer survivors?
This NCRP review highlights the critical need for comprehensive research and risk prediction models to address the late adverse effects of radiotherapy, specifically second malignant neoplasms and cardiovascular disease, in cancer survivors.
Second malignant neoplasms (SMNs) and cardiovascular disease (CVD) are among the most serious and life-threatening late adverse effects experienced by the growing number of cancer survivors worldwide and are due in part to radiotherapy. The National Council on Radiation Protection and Measurements (NCRP) convened an expert scientific committee to critically and comprehensively review associations between radiotherapy and SMNs and CVD, taking into account radiobiology; genomics; treatment (ie, radiotherapy with or without chemotherapy and other therapies); type of radiation; and quantitative considerations (ie, dose-response relationships). Major conclusions of the NCRP include: 1) the relevance of older technologies for current risk assessment when organ-specific absorbed dose and the appropriate relative biological effectiveness are taken into account and 2) the identification of critical research needs with regard to newer radiation modalities, dose-response relationships, and genetic susceptibility. Recommendation for research priorities and infrastructural requirements include 1) long-term large-scale follow-up of extant cancer survivors and prospectively treated patients to characterize risks of SMNs and CVD in terms of radiation dose and type; 2) biological sample collection to integrate epidemiological studies with molecular and genetic evaluations; 3) investigation of interactions between radiotherapy and other potential confounding factors, such as age, sex, race, tobacco and alcohol use, dietary intake, energy balance, and other cofactors, as well as genetic susceptibility; 4) focusing on adolescent and young adult cancer survivors, given the sparse research in this population; and 5) construction of comprehensive risk prediction models for SMNs and CVD to permit the development of follow-up guidelines and prevention and intervention strategies.
Travis et al. (Mon,) conducted a review in Cancer survivors at risk for second malignant neoplasms and cardiovascular disease. Radiotherapy was evaluated on Second malignant neoplasms and cardiovascular disease. The NCRP expert committee reviewed associations between radiotherapy and late adverse effects, concluding that older technologies remain relevant for current risk assessment when dose is considered.
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