Karlsson P, Holmberg E, Lundberg L M, Nordborg C, Wallgren A
Department of Oncology, Sahlgrenska University Hospital, Göteborg, Sweden.
Radiat Res. 1997 Aug;148(2):161-7.
The risk of developing intracranial tumors was studied in a Swedish cohort of 11,805 infants treated with 226Ra for hemangioma of the skin between 1930 and 1965. The cohort was followed up in the Swedish Cancer Register during the years 1958 through 1992, giving 402,958 person-years at risk. Forty-seven intracranial tumors developed in 46 individuals. The standardized incidence ratio (SIR) was 1.80 (95% CI 1.32-2.39). An excess number of cases was found for many histopathological subgroups, although the excess was statistically significant only for gliomas (n = 23, SIR 1.89, 95% CI 1.20-2.83) and meningiomas (n = 8, SIR 2.42, 95% CI 1.06-4.77). Absorbed doses to the brain have been calculated. The mean dose to the brain was only 7.2 cGy. The dose response was evaluated by Poisson regression methods. There was an excess of intracranial tumors in all dose categories, but no clear dose-response relationship could be seen for the data. This indicates that explanations other than irradiation may also be involved. The selection of the reference population has been studied and confirmed to be representative. For individuals treated before 7 months of age, however, the data could be fitted to both the linear and the linear-quadratic model. These results may indicate that the youngest infants may be more sensitive to ionizing radiation and that even very low doses to the brain may increase the risk for intracranial tumors.
对1930年至1965年间在瑞典接受226镭治疗皮肤血管瘤的11805名婴儿队列进行了颅内肿瘤发生风险的研究。该队列在1958年至1992年期间在瑞典癌症登记处进行随访，提供了402958人年的风险期。46名个体中发生了47例颅内肿瘤。标准化发病率（SIR）为1.80（95%可信区间1.32 - 2.39）。在许多组织病理学亚组中发现病例数过多，尽管仅胶质瘤（n = 23，SIR 1.89，95%可信区间1.20 - 2.83）和脑膜瘤（n = 8，SIR 2.42，95%可信区间1.06 - 4.77）的病例数过多具有统计学意义。已计算出大脑的吸收剂量。大脑的平均剂量仅为7.2 cGy。通过泊松回归方法评估剂量反应。在所有剂量类别中颅内肿瘤均有过多发生，但数据中未观察到明确的剂量反应关系。这表明除辐射外的其他因素也可能起作用。已对参考人群的选择进行研究并确认具有代表性。然而，对于7个月龄前接受治疗的个体，数据可拟合线性模型和线性 - 二次模型。这些结果可能表明最小的婴儿可能对电离辐射更敏感，即使大脑接受非常低的剂量也可能增加颅内肿瘤的风险。
