University of Southampton, Southampton, UK.
University Hospital Southampton, Southampton, UK.
Bone Joint J. 2019 Mar;101-B(3):241-245. doi: 10.1302/0301-620X.101B3.BJJ-2018-0663.R1.
The aim of this study was to quantify the risk of developing cancer from the exposure to radiation associated with surgery to correct limb deformities in children.
A total of 35 children were studied. There were 19 girls and 16 boys. Their mean age was 11.9 years (2 to 18) at the time of surgery. Details of the radiological examinations were recorded during gradual correction using a Taylor Spatial Frame. The dose area product for each radiograph was obtained from the Computerised Radiology Information System database. The effective dose in millisieverts (mSv) was calculated using conversion coefficients for the anatomical area. The lifetime risk of developing cancer was calculated using government-approved Health Protection Agency reports, accounting for the age and gender of the child.
Correction was undertaken in five femurs, 18 tibiae, and 12 feet. The median duration of treatment was 45 months (11 to 118). The mean effective dose was 0.31 mSv (0.05 to 0.64) for the femur, 0.29 mSv (0.01 to 0.97) for the tibia, and 0.027 mSv (0.001 to 0.161) for the foot. The cumulative exposure gave 'negligible' risk in 26 children and 'minimal' risk in nine children, according to Public Health England categories. These results are below the mean annual background radiation in the United Kingdom.
The lifetime attributable risk of developing cancer from repeated exposure to radiation was negligible or minimal in all children. This is the first study to quantify the exposure to radiation from serial radiographs in children with limb deformities who are treated surgically using circular external fixation, linking this to the risk of developing cancer. Cite this article: Bone Joint J 2019;101-B:241-245.
本研究旨在量化儿童肢体畸形矫正手术中因辐射暴露而罹患癌症的风险。
共纳入 35 名患者，其中 19 名女性，16 名男性，平均年龄为 11.9 岁（2 至 18 岁）。采用 Taylor 空间框架逐步矫正时记录了所有影像学检查的详细信息。每张射线照片的剂量面积乘积（DAP）均从计算机放射信息系统数据库中获得。有效剂量（mSv）根据解剖面积的转换系数进行计算。采用政府批准的英国健康保护局报告，结合儿童的年龄和性别，计算其终生患癌风险。
5 例股骨、18 例胫骨和 12 例足部接受了矫正治疗。中位治疗时间为 45 个月（11 至 118 个月）。股骨的平均有效剂量为 0.31 mSv（0.05 至 0.64），胫骨为 0.29 mSv（0.01 至 0.97），足部为 0.027 mSv（0.001 至 0.161）。根据英国公共卫生署的分类，26 名儿童的累积照射量风险“可忽略不计”，9 名儿童的风险“微不足道”。这些结果低于英国的年平均背景辐射。
所有儿童因反复接受辐射而罹患癌症的终身归因风险均为可忽略或微不足道。这是首例定量分析儿童肢体畸形采用环形外固定器手术矫正治疗时，连续 X 线照射与癌症发生风险之间关系的研究。
Bone Joint J 2019;101-B:241-245.
