Leukemia, Lymphoma, and Multiple Myeloma after Pelvic Radiotherapy for Benign Disease

作者：Peter D. Inskip, Ruth A. Kleinerman, Marilyn Stovall, Diane L. Cookfair, Olympia C. Hadjimichael, William Curry Moloney, Richard R. Monson, W. Douglas Thompson, Jean Wactawski‐Wende, Joseph K. Wagoner, John D. Boice · 发表于：Radiation Research · 年份：1993 · DOI：10.2307/3578404 · 被引用次数：90 · 研究领域：Endometrial and Cervical Cancer Treatments、Management of metastatic bone disease、Effects of Radiation Exposure

The relationship between exposure to sparsely ionizing radiation and mortality due to cancers of hematopoietic and lymphopoietic tissues was studied among 12,955 women treated for benign gynecological disorders at any of 17 hospitals in New England or New York State and followed for an average of 25 years; 9770 women were treated by radiation (intracavitary 226Ra, external-beam X rays), while 3185 were treated by other methods, including curettage, surgery, and hormones. The average age at treatment was 46.5 years, and the mean dose to active bone marrow among irradiated women was 119 cGy. Forty deaths due to acute, myelocytic, or monocytic leukemia were observed among irradiated women. This number was 70% higher than expected based on U.S. mortality rates [standardized mortality ratio (SMR) = 1.7; 90% confidence interval (CI) 1.3-2.3]. A deficit was recorded among nonirradiated women, based on three observed deaths (SMR = 0.5; 90% CI 0.1-1.2). A well-defined gradient in the SMR with dose among exposed women was not detected. The SMR was highest within 5 years after irradiation but remained elevated even after 30 years. The temporal pattern differed by subtype of leukemia: excess mortality due to chronic myelocytic leukemia occurred almost exclusively within the first 15 years, whereas the SMR for acute leukemia, though also elevated, varied little over time. Cancers of lymphoreticular tissue occurred more often than expected based on U.S. mortality rates, but not appreciably...