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. 2012 Nov;14(11):1316-24.
doi: 10.1093/neuonc/nos208. Epub 2012 Sep 5.

Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review

Melissa Z Braganza  1 , Cari M Kitahara, Amy Berrington de González, Peter D Inskip, Kimberly J Johnson, Preetha Rajaraman
Affiliations

Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review

Melissa Z Braganza et al. Neuro Oncol. 2012 Nov.

Abstract

Although exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for brain and CNS tumors, it is not clear whether this relationship differs across tumor subtypes, by sex or age at exposure, or at the low-to-moderate range of exposure. This systematic review summarizes the epidemiologic evidence on the association between ionizing radiation exposure and risk of brain/CNS tumors. Articles included in this review estimated radiation exposure doses to the brain and reported excess relative risk (ERR) estimates for brain/CNS tumors. Eight cohorts were eligible for inclusion in the analysis. Average age at exposure ranged from 8 months to 26 years. Mean dose to the brain ranged from 0.07 to 10 Gy. Elevated risks for brain/CNS tumors were consistently observed in relation to ionizing radiation exposure, but the strength of this association varied across cohorts. Generally, ionizing radiation was more strongly associated with risk for meningioma compared with glioma. The positive association between ionizing radiation exposure and risk for glioma was stronger for younger vs older ages at exposure. We did not observe an effect modification on the risk for meningioma by sex, age at exposure, time since exposure, or attained age. The etiologic role of ionizing radiation in the development of brain/CNS tumors needs to be clarified further through additional studies that quantify the association between ionizing radiation and risk for brain/CNS tumors at low-to-moderate doses, examine risks across tumor subtypes, and account for potential effect modifiers.

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Figures

Fig. 1.
Fig. 1.
Cohort-specific ERRs (95% CIs) for all brain/CNS tumors. The dots represent ERRs and the vertical lines correspond to CIs. Note that the definition of all brain/CNS varied across studies.
Fig. 2.
Fig. 2.
Cohort-specific ERRs (95% CIs) for glioma. The dots represent ERRs and the vertical lines correspond to CIs.
Fig. 3.
Fig. 3.
Cohort-specific ERRs (95% CIs) for meningioma. The dots represent ERRs and the vertical lines correspond to CIs. Note that the upper range for the British Childhood Cancer Survivor Study (17) is 107.7 and is not shown.
Fig. 4.
Fig. 4.
Cohort-specific and summary ERRs (95% CIs) for meningioma.
See this image and copyright information in PMC

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