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. 2013 Aug 1;86(5):922-9.
doi: 10.1016/j.ijrobp.2013.04.010. Epub 2013 May 22.

Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

Ruth A Kleinerman  1 , Susan A Smith, Eric Holowaty, Per Hall, Eero Pukkala, Leila Vaalavirta, Marilyn Stovall, Rita Weathers, Ethel Gilbert, Berthe M P Aleman, Magnus Kaijser, Michael Andersson, Hans Storm, Heikki Joensuu, Charles F Lynch, Graça M Dores, Lois B Travis, Lindsay M Morton, Rochelle E Curtis
Affiliations

Radiation dose and subsequent risk for stomach cancer in long-term survivors of cervical cancer

Ruth A Kleinerman et al. Int J Radiat Oncol Biol Phys. .

Abstract

Purpose: To assess the dose-response relationship for stomach cancer after radiation therapy for cervical cancer.

Methods and materials: We conducted a nested, matched case-control study of 201 cases and 378 controls among 53,547 5-year survivors of cervical cancer diagnosed from 1943 to 1995, from 5 international, population-based cancer registries. We estimated individual radiation doses to the site of the stomach cancer for all cases and to corresponding sites for the matched controls (overall mean stomach tumor dose, 2.56 Gy, range 0.03-46.1 and after parallel opposed pelvic fields, 1.63 Gy, range 0.12-6.3).

Results: More than 90% of women received radiation therapy, mostly with external beam therapy in combination with brachytherapy. Stomach cancer risk was nonsignificantly increased (odds ratio 1.27-2.28) for women receiving between 0.5 and 4.9 Gy to the stomach cancer site and significantly increased at doses ≥ 5 Gy (odds ratio 4.20, 95% confidence interval 1.41-13.4, Ptrend=.047) compared with nonirradiated women. A highly significant radiation dose-response relationship was evident when analyses were restricted to the 131 cases (251 controls) whose stomach cancer was located in the middle and lower portions of the stomach (Ptrend=.003), whereas there was no indication of increasing risk with increasing dose for 30 cases (57 controls) whose cancer was located in the upper stomach (Ptrend=.23).

Conclusions: Our findings show for the first time a significant linear dose-response relationship for risk of stomach cancer in long-term survivors of cervical cancer.

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Conflict of interest statement

Conflicts of Interest Notifications

There are no conflicts of interest to report.

Figures

Figure 1
Figure 1
External beam radiation doses (Gy) to stomach cancer sites by type of external beam radiation field used to treat cervical cancer (mean doses are indicated above each bar). Percent of cases and controls with known external beam fields are shown under each type of external beam field. Abbreviations; ant, anterior; post, posterior
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References

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