- March 6, 2012 – Online Registration Opens
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Radiation Exposure Assessment in Late Effects Studies: Overview of Available Methods and Design/Rationale of the DCOG Later Dosimetry Research Project
Berthe Aleman, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital
Keywords: Radiation dosimetry, Late effects, Childhood Cancer Survivors
Background Anticancer therapy is associated with adverse health effects. We are conducting a series of retrospective studies on medically assessed adverse events among long-term childhood cancer survivors in the Dutch DCOG LATER cohort, of whom ~3000 had radiotherapy between 1963 and 2001. We aim to (1) provide a review of available methods to quantify radiation effects in existing late effects studies and (2) describe rationale for and design of our Dosimetry Research Program.
Methods We conducted a review of available methods employed in studies on late effects of radiotherapy, including study design (i.e., cohort, case-control, patient series, etc.), methods to quantify radiation dose (patient chart based, type of dosimetry method employed, etc.), and the statistical/biological/mathematical models applied to derive quantitative risk estimates, including an assessment of pros and cons.
Results The literature review results will be summarized in a concise table. Cohort-wide data collection for absorbed radiation doses for multiple organs-at-risk is warranted and feasible and should allow for (a) valid comparison of patients treated for different cancer types at different ages and affecting different body parts; and (b) investigation of the potential contribution of volume and fractionation to risk estimates, important parameters according to radiobiology, yet rarely studied epidemiologically. We propose to construct a radiation exposure matrix, for homogeneous patient groups treated with similar radiotherapy, with measures of: organ-in-beam (y/n); absorbed dose; volume; and fractionation; for relevant organs, where feasible. This is probably not possible for any combination of past therapy and organ-at-risk. Nevertheless, this effort will serve DCOG LATER late effects studies and will allow for a descriptive analysis of radiotherapy methods in pediatric oncology in the past 50 years. Conclusions The DCOG LATER Dosimetry Research Program is unique in scope and will provide a solid basis for current and future retrospective quantitative studies on radiotherapy-related adverse events.