Abstract
Background and PurposeMost information on the dose-response of radiation-induced cancer is derived from data on the A-bomb survivors. Since, for radiation protection purposes, the dose span of main interest is between zero and one Gy, the analysis of the A-bomb survivors is usually focused on this range. However, estimates of cancer risk for doses larger than one Gy are becoming more important for radiotherapy patients. Therefore in this work, emphasis is placed on doses relevant for radiotherapy with respect to radiation induced solid cancer.Materials and methodsFor various organs and tissues the analysis of cancer induction was extended by an attempted combination of the linear-no-threshold model from the A-bomb survivors in the low dose range and the cancer risk data of patients receiving radiotherapy for Hodgkin's disease in the high dose range. The data were fitted using organ equivalent dose (OED) calculated for a group of different dose-response models including a linear model, a model including fractionation, a bell-shaped model and a plateau-dose-response relationship.ResultsThe quality of the applied fits shows that the linear model fits best colon, cervix and skin. All other organs are best fitted by the model including fractionation indicating that the repopulation/repair ability of tissue is neither 0 nor 100% but somewhere in between. Bone and soft tissue sarcoma were fitted well by all the models. In the low dose range beyond 1 Gy sarcoma risk is negligible. For increasing dose, sarcoma risk increases rapidly and reaches a plateau at around 30 Gy.ConclusionsIn this work OED for various organs was calculated for a linear, a bell-shaped, a plateau and a mixture between a bell-shaped and plateau dose-response relationship for typical treatment plans of Hodgkin's disease patients. The model parameters (α and R) were obtained by a fit of the dose-response relationships to these OED data and to the A-bomb survivors. For any three-dimensional inhomogenous dose distribution, cancer risk can be compared by computing OED using the coefficients obtained in this work.
Highlights
The dose-response relationship for radiation carcinogenesis up to one or two Gy has been quantified in several major analyses of the atomic bomb survivors data
In this work organ equivalent dose (OED) for various organs was calculated for a linear, a bellshaped, a plateau and a mixture between a bell-shaped and plateau dose-response relationship for typical treatment plans of Hodgkin’s disease patients
For any three-dimensional inhomogenous dose distribution, cancer risk can be compared by computing OED using the coefficients obtained in this work
Summary
The dose-response relationship for radiation carcinogenesis up to one or two Gy has been quantified in several major analyses of the atomic bomb survivors data. Recent papers have been published, for example, by Preston et al [1,2] and Walsh et al [3,4] This dose range is important for radiation protection purposes where low doses are of particular interest. There is currently much debate concerning the shape of the dose-response curve for radiation-induced cancer [5,6,7,8,9,10,11,12,13,14,15,16,17] It is not known whether cancer risk as a function of dose continues to be linear or decreases at high dose due to cell killing or levels off due to, for example, a balance between cell killing and repopulation effects. In this work, emphasis is placed on doses relevant for radiotherapy with respect to radiation induced solid cancer
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