Verduijn P G
Instituut voor Radio-epidemiologie, Reinaert Kliniek, Maastricht, The Netherlands.
Otolaryngol Head Neck Surg. 1996 Nov;115(5):417-21. doi: 10.1177/019459989611500510.
To study the late health effects of nasopharyngeal radium irradiation, a nonconcurrent prospective study was conducted in The Netherlands. Exposed subjects (n = 2510) were treated unilaterally with nasopharyngeal radium irradiation at five ear, nose, and throat clinics between 1945 and 1965 and followed up through February 1, 1985. Unexposed subjects (n = 2199) were matched to treated patients according to clinic, year of birth, and first consultation within 5 years. No overall significant increase in cancer mortality was found. A statistically significant difference was noted only for cumulative all-site cancer incidence, with the exposed having twice as many verified cancers as the nonexposed. This excess risk was caused mainly by head and neck tumors and other tumors (lung, digestive tract, and urogenital system). The relative risk for these specific sites, however, was not significantly different from 1.00. These findings corroborate the hypothesis that there is some risk of tumor induction involved with nasopharyngeal radium irradiation at the dose level applied to this population. Because of ongoing interest in this subject, I plan to extend the follow-up of the cohort through December 31, 1995, and I am studying the possibility of expanding the study population.
为研究鼻咽部镭辐射的远期健康影响，在荷兰开展了一项非同期前瞻性研究。1945年至1965年间，2510名受辐射者在五家耳鼻喉诊所接受了单侧鼻咽部镭辐射治疗，并随访至1985年2月1日。2199名未受辐射者根据诊所、出生年份和5年内的首次就诊情况与接受治疗的患者进行匹配。未发现癌症死亡率总体显著增加。仅在累积全部位癌症发病率方面发现有统计学意义的差异，受辐射者确诊癌症的数量是未受辐射者的两倍。这种额外风险主要由头颈部肿瘤和其他肿瘤（肺癌、消化道肿瘤和泌尿生殖系统肿瘤）引起。然而，这些特定部位的相对风险与1.00无显著差异。这些发现证实了这样一种假设，即在应用于该人群的剂量水平下，鼻咽部镭辐射存在一定的诱发肿瘤风险。由于对该课题持续关注，我计划将该队列的随访延长至1995年12月31日，并正在研究扩大研究人群的可能性。
