Bone Marrow Transplant 2000 May;25(9):1011-3 
<b>Radiation-induced bone sarcoma following total body irradiation: role of additional radiation on localized areas.</b> 
Kirova YM, Rafi H, Voisin MC, Rieux C, Kuentz M, Mouel SL, Levy E, Cordonnier C Oncology Department, Henri Mondor University Hospital, Creteil, France. [Record supplied by publisher] . 
&&url PMID: 10800073 


Pediatr Neurosurg 1998 Feb;28(2):63-6 
<b>Radiation exposure in the myelomeningocele population.</b> 
Gaskill SJ, Marlin AE. Pediatric Neurosurgery of South Texas, P.A., San Antonio, USA.
Radiation-induced carcinoma is known to occur with lower doses of radiation exposure than previously recognized. The myelomeningocele population, because of its complex medical problems, is exposed to relatively high doses of radiation from diagnostic radiographs performed throughout their lives...These data suggest that the radiation burden from diagnostic radiographs in the myelomeningocele population may ultimately contribute to carcinogenesis, mutagenesis and other radiation damage. Specific strategies for reducing the lifetime radiographic exposure in these patients are discussed in detail. 
&&url PMID: 9693333 


Environ Health Perspect 1997 Dec;105 Suppl 6:1497-8 
<b>Thyroid-stimulating hormone levels in children from Chernobyl.</b>
Quastel MR, Goldsmith JR, Mirkin L, Poljak S, Barki Y, Levy J, Gorodischer R. Soroka Medical Center, Beer Sheva, Israel. maay100@bgumail.bgu.ac.il 
This study assesses parameters of thyroid function in persons who resided in Ukraine, Belarus, and southern Russia and exposed at 0 to 16 years of age to radioiodine contamination from the Chernobyl accident.... <b>A working hypothesis is proposed by which the shift in TSH levels in girls from high radiocontamination areas was associated with subclinical radiation damage from environmental radioiodine at the time of the accident.</b> 
&&url PMID: 9467071 


Stem Cells 1997;15 Suppl 2:207-10 
<b>Overview of 1993 research activities in Belarus related to the Chernobyl accident.</b> 
Krissenko N. Belarus Ministry of Health, Minsk, Belarus. 
This overview describes the medical and biological consequences of the Chernobyl nuclear power plant accident that had been assessed by Belarus scientists as of 1993. <b>In particular, childhood thyroid cancer has increased in both frequency and severity. Other malignant tumors may have also increased, as may have childhood diseases that result from impaired immune function. It is unknown whether these increases in human disease (other than thyroid cancer) are due to improved methods of reporting or to exposure to ionizing radiation. In addition to the medical consequences of radiation damage, there are also significant psychological problems endured by the population living in contaminated areas.</b> The Republic of Belarus has participated in several international programs for the study and management of widespread radiation exposure, and will continue to do so. Programs to address issues of radiation protection and population safety are being implemented wherever possible. 
&&url PMID: 9368306 


Med Pediatr Oncol 1997 Dec;29(6):568-72 
<b>Treatment of childhood post-irradiation sarcoma of bone in cancer survivors.</b> 
Cefalo G, Ferrari A, Tesoro-Tess JD, Gianni MC, Fossati-Bellani F, Lombardi F, Massimino M. Division of Pediatric Oncology, Istituto Nazionale Tumori, Milano, Italy. 

... This is a retrospective review of five children with post-irradiation bone sarcoma (PIS). ... Chemotherapy alone, using an intensive regimen effective for primary osteogenic sarcoma, may be an adequate therapy for childhood post-irradiation sarcoma. 
&&url PMID: 9324346


Radiat Res 1997 May;147(5):579-84 
<b>Unexpected rates of chromosomal instabilities and alterations of hormone levels in Namibian uranium miners.</b> 
Zaire R, Notter M, Riedel W, Thiel E. Department of Hematology and Oncology, University Medical Centre, Benjamin Franklin, Free University Berlin, Germany. 
A common problem in determining the health consequences of radiation exposure is factoring out other carcinogenic influences. The conditions in Namibia provide a test case for distinguishing the effects of long-term low-dose exposure to uranium from the other environmental factors because of good air quality and the lack of other industries with negative health effects. Present records indicate a much higher prevalence of cancer among male workers in the open-pit uranium mine in Namibia compared with the general population. The objective of the present study was to determine whether long-term exposure to low doses of uranium increases the risk of a biological radiation damage which would lead to malignant diseases .... A representative cohort of 75 non-smoking, HIV-negative miners was compared to a control group of 31 individuals with no occupational history in mining. A sixfold increase in uranium excretion among the miners compared to the controls was recorded (P < 0.001). Furthermore, we determined a significant reduction in testosterone levels (P < 0.008) and neutrophil count (P < 0.004) in miners compared to the unexposed controls. A threefold increase in chromosome aberrations in the miners compared to the nonexposed controls was recorded (P < 0.0001). Most remarkably, cells with multiple aberrations such as "rogue" cells were observed for the first time in miners; these cells had previously been found only after short-term high-dose radiation exposure, e.g. from the Hiroshima atomic bomb or the Chernobyl accident. We conclude that the miners exposed to uranium are at an increased risk to acquire various degrees of genetic damage, and that the damage may be associated with an increased risk for malignant transformation. As expected, the chronic radiation injury of the hematopoietic system resulted in low neutrophil counts. Also, low hormone levels probably reflect damage to the gonadal endocrine system. 
&&url PMID: 9146703 


Pediatr Hematol Oncol 1995 Mar-Apr;12(2):185-8 Comment in: Pediatr Hematol Oncol. 1995 Mar-Apr;12(2):111-3 
<b>Acute lymphoblastic leukemia in a girl treated for osteosarcoma.</b> 
Miniero R, Barisone E, Vivenza C, Brach del Prever A, Besenzon L, Cordero di Montezemolo L, Madon E. Department of Pediatrics, University of Turin, Italy. 
&&url PMID: 7626388 


J Natl Cancer Inst 1994 Jun 1;86(11):842-9 
<b>Cancer following radiotherapy for peptic ulcer.</b> 
Griem ML, Kleinerman RA, Boice JD Jr, Stovall M, Shefner D, Lubin JH. Department of Radiation Oncology, University of Chicago, Ill 60637. 
BACKGROUND: <b>Radiotherapy for peptic ulcer was used between 1937 and 1965 to control excessive gastric acid secretions (mean dose, 14.8 Gy). Patients with this benign condition live many years after treatment and are at risk for late effects.</b> PURPOSE: Our purpose was to investigate the risk of death from cancer following radiotherapy for peptic ulcer. METHODS: <b>A mortality study was conducted of 3609 patients with peptic ulcer; 1831 were treated with radiation and 1778 were treated by other means. Extensive methods were used to trace patients. Radiation doses to specific organs were reconstructed from the original radiotherapy records.</b> RESULTS: <b>Nearly 70% of patients were found to have died. The average period of observation was 21.5 years (maximum 51 years). Compared with the general population, patients treated with or without radiation were at significantly increased risk of dying of cancer and non-malignant diseases of the digestive system. Risk of death due to heart disease was slightly higher following radiotherapy. Cancers of the stomach, pancreas, lung, and prostate were increased in both irradiated and nonirradiated patients. Radiotherapy was linked to significantly high relative risks (RRs) for all cancers combined (RR = 1.53; 95% confidence interval [CI] = 1.3-1.8), for cancers of the stomach (RR = 2.77; 95% CI = 1.6-4.8), pancreas (RR = 1.87; 95% CI = 1.0-3.4), and lung (RR = 1.70; 95% CI = 1.2-2.4), and for leukemia (RR = 3.28; 95% CI = 1.0-10.6). Radiation combined with surgery, or given to treat gastric ulcer, appeared to increase the risk of stomach cancer 10-fold, which was greater than the sum of individual effects. Patients with gastric ulcers were at higher risk for stomach cancer than patients with duodenal ulcers.</b>  CONCLUSIONS: <b>Patients with peptic ulcer are at increased risk of dying of cancer, related in part to lifestyle factors and treatment. Radiotherapy and surgery together appear to induce carcinogenic processes that greatly enhance the development of stomach cancer. The risk of radiation-induced stomach cancer was 0.25 extra deaths per 10,000 persons per year per Gy, somewhat lower than reported in other studies. High-dose radiation may have increased the risk of pancreatic cancer, a condition rarely found elevated in irradiated populations, but misclassified death notices may have contributed to the excess. Cancer mortality remained high for up to 50 years, indicating that radiation damage may persist to the end of life.</b>  
&&url PMID: 8182765 


Eur J Surg Oncol 1994 Feb;20(1):53-6
<b>Post irradiation sarcoma of soft tissue and bone.</b> 
Pitcher ME, Davidson TI, Fisher C, Thomas JM. Sarcoma Unit, Royal Marsden Hospital, London, UK. 
Thirty-eight patients with sarcomas of soft tissue and bone which followed previous radiotherapy have been treated at the Royal Marsden Hospital between 1951 and 1992. The ... median time to development of sarcoma was 11 years. The only long term survivors were those who had complete surgical excision. Seven patients required forequarter amputation (30% of the extremity sarcomas) which reflects their frequent situation in the shoulder girdle and upper arm and the close proximity to the brachial plexus and vascular bundle. The overall prognosis was poor (5-year survival 30%) and probably reflects the poor prognostic factors (size, grade and tumour site) present at the time of diagnosis. 
&&url PMID: 8131870 


J Submicrosc Cytol 1987 Apr;19(2):365-9
<b>Post-irradiation leiomyosarcoma. Case report with immunohistochemical studies.</b> 
Korbi S, Meyer D, Skalli O, Gabbiani G, Kapanci Y. 
We report here one case of post-irradiation leiomyosarcoma. The diagnosis of this was confirmed using anti-intermediate filament antibodies: tumor cells were positive for anti-vimentin and anti-desmin but negative for anti-prekeratin and anti-epithelial membrane antigen. The positive staining with anti-desmin clearly indicates a muscular origin although the tumor cells were not stained by two anti-actin antibodies, one directed against alpha-smooth muscle actin and the other against alpha-striated muscle actin. Irradiation was motivated by a wrong diagnosis of breast carcinoma when the patient was 13 year-old. The laps of time separating irradiation and the occurrence of the leiomyosarcoma was 13 years. The total dose was 6,000 rads. <b>This is the ninth case of post-irradiation leiomyosarcomas reported in the literature.</b> 
&&url PMID: 2439703 


J Dermatol Surg Oncol 1984 Mar;10(3):200-3 
<b>Radiation-induced basal-cell carcinoma.</b> 
Allison JR Jr. 
Four patients developed 129 basal-cell carcinoma (BCC) in areas of prior radiation without evidence of radiation damage. The time lag between radiation and appearance of the cancers was 20 years. It is proposed that we are dealing with a subset of the population not previously recognized. These patients were not related to other groups, such as the nevoid basal-cell carcinoma syndrome. 
&&url PMID: 6699258 


Ann Acad Med Singapore 1981 Jul;10(3):267-76 
<b>Radiation induced cancer: a report of 10 cases.</b> 
Tan BC, Chia KB. 
Ionizing radiations have been shown to be carcinogenic to man as well as experimental animals. Malignancies following therapeutic radiation occur rarely. Over the past 10 years the authors recorded 10 cases of tumours in irradiated tissues. ... The clinical features of these cases are discussed and other cases reported in the literature are reviewed. 
&&url PMID: 6277226 


Cancer 1979 Nov;44(5):1601-5
<b>Breast carcinoma and basal cell epithelioma after x-ray therapy for hirsutism.</b> 
Schwartz RA, Burgess GH, Milgrom H. 

We report a 60-year-old woman with a history of x-ray therapy for generalized hirsutism at 20 years of age who at the age of 37 years developed the first of numerous basal cell epitheliomas on her trunk, including chest, on a background of radiation damaged skin. At the age of 51 years one of the basal cell epitheliomas was biopsied and an incidental histologic finding was a breast carcinoma. <b>The basal cell epithelioma is clearly linked with x-ray exposure; breast cancer is less so although there is impressive epidemiologic evidence supporting an association between human breast cancer and radiation exposure.</b> In view of an <b>association between thyroid cancer and dermatologic x-ray therapy,</b> further investigation of such an association with breast cancer should be considered. <b>It may be wise to evaluate patients who received dermatologic x-ray exposure to their breasts for possible breast cancer and to consider radiation induced skin damage on or near the skin overlying the thyroid or breasts as a cutaneous marker of internal malignancy or potential internal malignancy.</b> 
&&url PMID: 498032 


CRC Crit Rev Clin Radiol Nucl Med 1975 Jul;6(3):425-39
<b>A survey of the benefits and risks in the practice of radiology.</b> 
Payne JT, Loken MK. 
The findings from both animal and human studies on the radiation risk at low doses and low dose rates are far from conclusive, primarily due to statistical limitations. However, to arrive at some estimate of radiation risk, a conservative approach has been taken, and a linear extrapolation of radiation effects from high doses to low doses has been made. Thus, it is assumed that any exposure to radiation carries some risk of somatic or genetic damage and that there is no threshold or safe dose. In medical practice, diagnostic radiological procedures should be performed only if useful clinical information will be derived. In addition, this information should be obtained at the least possible risk to the patient. For mass chest X-rays, mammography, and lung scans, a quantitative determination of benefit to risk is developed. This approach, though possible desirable, is exceedingly difficult to establish for most diagnostic radiological procedures. Thus, good clinical judgement should be employed in radiological practice, just as it should be employed in all aspects of medical practice. 
&&url PMID: 1097189 


Minerva Ginecol 1997 Jul-Aug;49(7-8):345-54 
<b>[Radiotherapy of cancer of the uterine cervix and successive appearance of new malignant growth in the irradiated field].</b> [Article in Italian] 
Russo F, Spina C, Coscarella G, Sileri PP, Arturi A, Stolfi VM Dipartimento di Chirurgia, Universita degli Studi di Roma Tor Vergata. [Record supplied by publisher] 
Among the late complications of high-dosage pelvic radiotherapy for cervical cancer, anorectal and bladder malignancies are sporadically reported in the literature. In this study the possible relationships of previous radiotherapy with late appearance of neoplasms are analyzed and in particular post-radiotherapy interval, dosage and type or irradiation to the cervical area. The mechanisms or neoplastic transformation or irradiated tissues are also studied. ..., the possible cause-effect relationships between previous radiotherapy and subsequent appearance of neoplasms are analyzed as well as the potential therapeutical consequences or considering these women high-risk subjects. The usefulness or recruiting women with history or previous radiotherapy for cervical cancer in a strict follow-up program (ultrasonography, cytology and endoscopy) is suggested in order to make an early diagnosis of the new pelvic malignancy with a better possibility for treatment. Review, tutorial 
&&url PMID: 9380297