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Article: Exposure to ionizing radiation and development of bone sarcoma: New insights based on atomic-bomb survivors of Hiroshima and Nagasaki

TitleExposure to ionizing radiation and development of bone sarcoma: New insights based on atomic-bomb survivors of Hiroshima and Nagasaki
Authors
KeywordsAtomic bomb survivor
Bone marrow
Cohort analysis
Demography
Disease association
Issue Date2011
PublisherJournal of Bone and Joint Surgery. The Journal's web site is located at http://www.jbjs.org
Citation
Journal Of Bone And Joint Surgery - Series A, 2011, v. 93 n. 11, p. 1008-1015 How to Cite?
AbstractBackground: Radiation-induced bone sarcoma has been associated with high doses of ionizing radiation from therapeutic or occupation-related exposures. However, the development of bone sarcoma following exposure to lower doses of ionizing radiation remains speculative. Methods: A cohort analysis based on the Life Span Study (n = 120,321) was performed to assess the development of bone sarcoma in atomic-bomb survivors of Hiroshima and Nagasaki followed from 1958 to 2001. The excess relative risk per gray of ionizing radiation absorbed by the bone marrow was estimated. Additional subject demographic, survival, and clinical factors were evaluated. Results: Nineteen cases of bone sarcoma (in eleven males and eight females) were identified among the 80,181 subjects who met the inclusion criteria, corresponding to an incidence of 0.9 per 100,000 person-years. The mean ages at the time of the bombing and at diagnosis were 32.4 and 61.6 years, respectively. Themean bonemarrow dose was 0.43 Gy. Osteosarcoma was the most commonly identified bone sarcoma. The most common bone sarcoma site was the pelvis. The overall unadjusted five-year survival rate was 25%. A dose threshold was found at 0.85 Gy (95% confidence interval, 0.12 to 1.85 Gy), with a linear dose-response association above this threshold. The linear slope equaled an excess relative risk of 7.5 per Gy (95% confidence interval, 1.34 to 23.14 per Gy) in excess of 0.85 Gy. Conclusions: On the basis of what we believe is one of the longest and largest prospective studies assessing the development of bone sarcoma in individuals exposed to ionizing radiation, it appears that the development of radiation-induced bone sarcomamay be associated with exposure tomuch lower doses of ionizing radiation than have previously been reported. Such new insights may potentially improve bone sarcoma preventionmeasures and broaden our understanding of the role of ionizing radiation from various sources on the development of malignant tumors. This study stresses the need to become increasingly aware of the various health risks that may be attributable to even low levels of ionizing radiation exposure. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated.
Persistent Identifierhttp://hdl.handle.net/10722/137445
ISSN
2023 Impact Factor: 4.4
2023 SCImago Journal Rankings: 1.705
ISI Accession Number ID
Funding AgencyGrant Number
U.S. Department of Energy
Radiation Effects Research Foundation of Hiroshima and Nagasaki, Japan
Japanese Ministry of Health, Labour and WelfareRP 1-75
18-61
U.S. Department of Energy (in part through the U.S. National Academy of Sciences)
Funding Information:

In support of their research for or preparation of this work, one or more of the authors received outside funding or grants in excess of $10,000 from the U.S. Department of Energy. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

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DC FieldValueLanguage
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorNishi, Nen_HK
dc.contributor.authorHayashi, Men_HK
dc.contributor.authorCologne, Jen_HK
dc.contributor.authorCullings, HMen_HK
dc.contributor.authorKodama, Ken_HK
dc.contributor.authorMiles, EFen_HK
dc.contributor.authorFunamoto, Sen_HK
dc.contributor.authorSuyama, Aen_HK
dc.contributor.authorSoda, Men_HK
dc.contributor.authorKasagi, Fen_HK
dc.date.accessioned2011-08-26T14:25:15Z-
dc.date.available2011-08-26T14:25:15Z-
dc.date.issued2011en_HK
dc.identifier.citationJournal Of Bone And Joint Surgery - Series A, 2011, v. 93 n. 11, p. 1008-1015en_HK
dc.identifier.issn0021-9355en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137445-
dc.description.abstractBackground: Radiation-induced bone sarcoma has been associated with high doses of ionizing radiation from therapeutic or occupation-related exposures. However, the development of bone sarcoma following exposure to lower doses of ionizing radiation remains speculative. Methods: A cohort analysis based on the Life Span Study (n = 120,321) was performed to assess the development of bone sarcoma in atomic-bomb survivors of Hiroshima and Nagasaki followed from 1958 to 2001. The excess relative risk per gray of ionizing radiation absorbed by the bone marrow was estimated. Additional subject demographic, survival, and clinical factors were evaluated. Results: Nineteen cases of bone sarcoma (in eleven males and eight females) were identified among the 80,181 subjects who met the inclusion criteria, corresponding to an incidence of 0.9 per 100,000 person-years. The mean ages at the time of the bombing and at diagnosis were 32.4 and 61.6 years, respectively. Themean bonemarrow dose was 0.43 Gy. Osteosarcoma was the most commonly identified bone sarcoma. The most common bone sarcoma site was the pelvis. The overall unadjusted five-year survival rate was 25%. A dose threshold was found at 0.85 Gy (95% confidence interval, 0.12 to 1.85 Gy), with a linear dose-response association above this threshold. The linear slope equaled an excess relative risk of 7.5 per Gy (95% confidence interval, 1.34 to 23.14 per Gy) in excess of 0.85 Gy. Conclusions: On the basis of what we believe is one of the longest and largest prospective studies assessing the development of bone sarcoma in individuals exposed to ionizing radiation, it appears that the development of radiation-induced bone sarcomamay be associated with exposure tomuch lower doses of ionizing radiation than have previously been reported. Such new insights may potentially improve bone sarcoma preventionmeasures and broaden our understanding of the role of ionizing radiation from various sources on the development of malignant tumors. This study stresses the need to become increasingly aware of the various health risks that may be attributable to even low levels of ionizing radiation exposure. Level of Evidence: Prognostic Level I. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated.en_HK
dc.languageengen_US
dc.publisherJournal of Bone and Joint Surgery. The Journal's web site is located at http://www.jbjs.orgen_HK
dc.relation.ispartofJournal of Bone and Joint Surgery - Series Aen_HK
dc.subjectAtomic bomb survivor-
dc.subjectBone marrow-
dc.subjectCohort analysis-
dc.subjectDemography-
dc.subjectDisease association-
dc.titleExposure to ionizing radiation and development of bone sarcoma: New insights based on atomic-bomb survivors of Hiroshima and Nagasakien_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0021-9355&volume=93&issue=11&spage=1008&epage=1015&date=2011&atitle=Exposure+to+ionizing+radiation+and+the+development+of+bone+sarcoma:+new+insights+based+on+atomic-bomb+survivors+of+Hiroshima+and+Nagasaki-
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.2106/JBJS.J.00256en_HK
dc.identifier.pmid21984980-
dc.identifier.scopuseid_2-s2.0-79961057827en_HK
dc.identifier.hkuros189128en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79961057827&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume93en_HK
dc.identifier.issue11en_HK
dc.identifier.spage1008en_HK
dc.identifier.epage1015en_HK
dc.identifier.eissn1535-1386-
dc.identifier.isiWOS:000291132500004-
dc.publisher.placeUnited Statesen_HK
dc.relation.projectDevelopmental genomics and skeletal research-
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridNishi, N=7103131706en_HK
dc.identifier.scopusauthoridHayashi, M=35595547700en_HK
dc.identifier.scopusauthoridCologne, J=7004075047en_HK
dc.identifier.scopusauthoridCullings, HM=35067866700en_HK
dc.identifier.scopusauthoridKodama, K=7401760021en_HK
dc.identifier.scopusauthoridMiles, EF=16835150200en_HK
dc.identifier.scopusauthoridFunamoto, S=6701926077en_HK
dc.identifier.scopusauthoridSuyama, A=7006469043en_HK
dc.identifier.scopusauthoridSoda, M=35445053000en_HK
dc.identifier.scopusauthoridKasagi, F=21635323400en_HK
dc.identifier.issnl0021-9355-

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