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Evaluation of Second Cancer Induction Risk by CT Follow-up in Oncological Long-surviving Patients.
MedLine Citation:
PMID:  23192082     Owner:  NLM     Status:  Publisher    
ABSTRACT: The goal of establishing prompt localization of the malignant spread or recurrence of a tumor has found a powerful solution in the definition of follow-up protocols, which include the indication for CT scans on an annual or semiannual basis. In the case of long-surviving patients, however, this approach will lead to a considerable integrated dose level over a period of several years after recovery from the illness. Pathologies treated primarily by surgery and/or chemotherapy have been considered, not taking into account cancers treated with adjuvant or radical radiotherapy. Given that the most likely protocols for these cancers often call for total body scans, an estimation of the consequent effective and organ doses can be performed with acceptable accuracy. The data acquired from five centers have been collected and the related effective and organ doses calculated by means of IMPACT software. Use of the effective dose concept, however, has lately become the subject of criticism, and the recently proposed Effective Risk Model has therefore also been applied. The evaluated absolute additional risk of second tumor induction ranges between 0.1% and 10%, depending primarily on age and pathology. These results depict this additional risk as an issue of significant importance for clinical practice. A revision of follow-up and scan parameter protocols, as well as the introduction of new algorithms for dose reduction, could significantly improve the risk-benefit ratio for all the pathologies studied.Health Phys. 104(1):1-8; 2013.
R Calandrino; V Ardu; D Corletto; A Del Vecchio; D Origgi; P Signorotto; A Spinelli; G Tosi; A Bolognesi; M Cariati; A Kluzer; S Muscarella
Publication Detail:
Journal Detail:
Title:  Health physics     Volume:  104     ISSN:  1538-5159     ISO Abbreviation:  Health Phys     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-11-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985093R     Medline TA:  Health Phys     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-8     Citation Subset:  -    
*Medical Physics Department, San Raffaele Scientific Institute, Via Olgettina 60, Milano, Italy; †Medical Physics Department, A.O. Ospedale di Circolo di Busto Arsizio, via Arnaldo da Brescia 1, Busto Arsizio (Varese), Italy; ‡Medical Physics Department, Istituto Oncologico Europeo, Via Ripamonti 435, Milano, Italy; §Medical Physics Department, Istituto Clinico Humanitas, Via Manzoni 56 - Rozzano (Milano), Italy; **Radiotherapy Department, San Raffaele Scientific Institute, Via Olgettina 60, Milano, Italy; ††Radiology Department, A.O. S. Carlo Borromeo, Via Pio III, Milano, Italy; ‡‡Radiology Department, Istituto Clinico Humanitas, Via Manzoni 56, Rozzano, Milano, Italy.
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