Ronckers Cécile M, Land Charles E, Hayes Richard B, Verduijn Pieter G, Stovall Marilyn, van Leeuwen Flora E
Department of Ear, Nose and Throat Medicine, Reinaert Kliniek, Maastricht, The Netherlands.
Pediatr Res. 2002 Dec;52(6):850-8. doi: 10.1203/00006450-200212000-00007.
Nasopharyngeal radium irradiation (NRI) was widely used from 1940 through 1970 to treat otitis serosa in children and barotrauma in airmen and submariners. We assessed whether NRI-exposed individuals were at higher risk for benign tumors, nonmelanoma skin cancer, thyroid disorders, and conditions related to regulatory control of anterior pituitary hormones, such as growth and reproductive characteristics. We conducted a retrospective cohort study in 3,440 NRI-exposed and 3,088 nonexposed subjects, who as children were treated at nine ear, nose and throat clinics in The Netherlands between 1945 and 1981. Based on information from original medical records, we traced vital status through follow-up at municipal population registries. Disease status (including medical confirmation) and indicators of pituitary gland radiation damage were assessed from a self-administered questionnaire in 1997. The average radiation doses were 11, 7, and 1.5 cGy for pituitary, parotid, and thyroid gland, respectively, and 3.2 cGy for the facial skin. Among exposed subjects, 23 benign head and neck tumors were observed, compared with 21 among nonexposed subjects. Elevated risk of basal cell carcinoma of the head and neck area was observed in exposed subjects (odds ratio = 2.6; 95% confidence interval: 1.0-6.7). Exposed and nonexposed groups did not differ substantially with regard to thyroid disorders, height, and reproductive characteristics, although exposed males more frequently reported a history of fertility problems compared with nonexposed males (odds ratio = 1.4; 95% confidence interval: 1.0-2.1). We found no evidence of highly elevated risk of benign head and neck tumors, nonmelanoma skin cancer, thyroid disorders, or indicators of pituitary radiation damage after childhood NRI in The Netherlands.
1940年至1970年期间，鼻咽部镭照射（NRI）被广泛用于治疗儿童浆液性中耳炎以及飞行员和潜水艇船员的气压伤。我们评估了接受NRI照射的个体患良性肿瘤、非黑素瘤皮肤癌、甲状腺疾病以及与垂体前叶激素调节控制相关病症（如生长和生殖特征）的风险是否更高。我们对3440名接受NRI照射的受试者和3088名未接受照射的受试者进行了一项回顾性队列研究，这些受试者在1945年至1981年间于荷兰的九家耳鼻喉诊所接受儿童时期的治疗。根据原始医疗记录中的信息，我们通过在市政人口登记处进行随访来追踪生命状态。1997年通过一份自填式问卷评估疾病状态（包括医学确认）和垂体辐射损伤指标。垂体、腮腺和甲状腺的平均辐射剂量分别为11、7和1.5厘戈瑞，面部皮肤为3.2厘戈瑞。在接受照射的受试者中，观察到23例头颈部良性肿瘤，未接受照射的受试者中有21例。在接受照射的受试者中观察到头颈部基底细胞癌风险升高（优势比 = 2.6；95%置信区间：1.0 - 6.7）。尽管与未接受照射的男性相比，接受照射的男性更频繁地报告有生育问题史（优势比 = 1.4；95%置信区间：1.0 - 2.1），但在甲状腺疾病、身高和生殖特征方面，接受照射组和未接受照射组没有显著差异。我们没有发现证据表明荷兰儿童时期接受NRI照射后，头颈部良性肿瘤、非黑素瘤皮肤癌、甲状腺疾病或垂体辐射损伤指标的风险会大幅升高。
