Brain cancer after radiation exposure from CT examinations of children and young adults: results from the EPI-CT cohort study

作者：Michael Hauptmann, Graham B Byrnes, Elisabeth Cardis, Marie‐Odile Bernier, Maria Blettner, Jérémie Dabin, Hilde Engels, Tore S. Istad, Christoffer Johansen, Magnus Kaijser, Kristina Kjærheim, Neige Journy, Johanna M. Meulepas, Monika Moissonnier, Cécile M. Ronckers, Isabelle Thierry-Chef, Lucian Le Cornet, Andréas Jahnen, Roman Michael Pokora, Magda Bosch de Basea, Jordi Figuerola, Carlo Maccia, Arvid Nordenskjöld, Richard William Harbron, Choonsik Lee, Steven L. Simon, Amy Berrington de González, Joachim Schüz, Ausrele Kesminiene · 发表于：The Lancet Oncology · 年份：2022 · DOI：10.1016/s1470-2045(22)00655-6 · 被引用次数：269 · 研究领域：Radiation Dose and Imaging、Glioma Diagnosis and Treatment、Medical Imaging Techniques and Applications

BACKGROUND: The European EPI-CT study aims to quantify cancer risks from CT examinations of children and young adults. Here, we assess the risk of brain cancer. METHODS: We pooled data from nine European countries for this cohort study. Eligible participants had at least one CT examination before age 22 years documented between 1977 and 2014, had no previous diagnosis of cancer or benign brain tumour, and were alive and cancer-free at least 5 years after the first CT. Participants were identified through the Radiology Information System in 276 hospitals. Participants were linked with national or regional registries of cancer and vital status, and eligible cases were patients with brain cancers according to WHO International Classification of Diseases for Oncology. Gliomas were analysed separately to all brain cancers. Organ doses were reconstructed using historical machine settings and a large sample of CT images. Excess relative risks (ERRs) of brain cancer per 100 mGy of cumulative brain dose were calculated with linear dose-response modelling. The outcome was the first reported diagnosis of brain cancer after an exclusion period of 5 years after the first electronically recorded CT examination. FINDINGS: We identified 948 174 individuals, of whom 658 752 (69%) were eligible for our study. 368 721 (56%) of 658 752 participants were male and 290 031 (44%) were female. During a median follow-up of 5·6 years (IQR 2·4-10·1), 165 brain cancers occurred, including 121 (73%) gliom...