Abstract
The risk of iatrogenic tumors with radiation therapy is so outweighed by the benefit of cure that estimates of risk have not been considered necessary. However, the introduction of chemotherapy, combined therapy and particle radiation therapy necessitates examination of comparative risks. In the case of radiation, total dose, fractionation, dose rate, dose distribution and radiation quality should all be considered in the estimation of risk. The biological factors that must be considered include incidence of tumors, latent period, degree of malignancy and multiplicity of tumors. The risk of radiation induction of tumors is further influenced by the genotype, sex and age of the patient, the tissues that will be exposed, and previous therapy. With chemotherapy, the number of cells at risk is usually markedly higher than with radiation therapy. Clearly the problem of the estimation of comparative risks is complex. This paper presents the current views on the comparative risk and the importance of the various factors that influence the estimation of risk.
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