Hubert D, Bertin M
Comité de radioprotection-EDF, Paris, France.
Bull Cancer. 1993 Nov;80(11):971-83.
The risk of developing a tumor of the nervous system in humans is analysed in several studies of populations, exposed to ionising radiation for medical reasons, or exposed to military or occupational radiation. The main data come from series of patients who underwent radiotherapy during childhood: a high incidence of tumors of the nervous system is found after irradiation of one to a few grays as treatment of a benign disease (especially tinea capitis), as well as after irradiation at higher doses of a few tens of grays for the treatment of cancer (in particular cerebral irradiation in acute lymphoblastic leukaemia). The type of radiation-induced tumors is variable, but meningioma is more frequent after low doses and glioma and sarcoma after higher doses used in the treatment of neoplastic diseases. A dose-effect relationship appeared between the risk of tumor of the nervous system and the radiation dose. The risk was higher when radiation was delivered at a younger age. Much less data are available after radiotherapy in the adulthood, but an increased risk of cerebral tumor appears in the series of ankylosing spondylitis patients. As for the exposures to radiodiagnosis exams, the main problem is the risk of cerebral tumor in children whose mother has undergone abdominal or pelvic X-rays during pregnancy. No risk of neurologic tumor was found in the A-bomb survivors irradiated at Hiroshima and Nagasaki. Occupational exposure to ionising radiation has been incriminated in the first radiologists exposed to high doses. In nuclear industry workers, the results of epidemiological studies are contradictory and at the present time it is not possible to link their radiologic exposure with a risk of tumor of the nervous system. In populations living near nuclear plants, mortality due to tumors of the nervous system was not increased.
在一些针对因医疗原因接受电离辐射、军事辐射或职业辐射人群的研究中,分析了人类患神经系统肿瘤的风险。主要数据来自童年时期接受过放疗的一系列患者:作为良性疾病(尤其是头癣)的治疗,接受1至几格雷的辐射后,以及作为癌症治疗(特别是急性淋巴细胞白血病的脑部照射)接受几十格雷的更高剂量辐射后,都发现神经系统肿瘤的发病率很高。辐射诱发肿瘤的类型各不相同,但低剂量辐射后脑膜瘤更为常见,而在肿瘤疾病治疗中使用较高剂量辐射后,胶质瘤和肉瘤更为常见。神经系统肿瘤风险与辐射剂量之间呈现出剂量效应关系。辐射在较年轻时进行时,风险更高。成年后放疗后的相关数据要少得多,但在强直性脊柱炎患者系列中出现了脑肿瘤风险增加的情况。至于接受放射诊断检查,主要问题是母亲在怀孕期间接受腹部或盆腔X光检查的儿童患脑肿瘤的风险。在广岛和长崎受到原子弹辐射的幸存者中未发现神经肿瘤风险。首批接触高剂量辐射的放射科医生被认为存在职业性电离辐射暴露问题。在核工业工人中,流行病学研究结果相互矛盾,目前无法将他们的辐射暴露与神经系统肿瘤风险联系起来。在核电站附近居住的人群中,神经系统肿瘤导致的死亡率并未增加。