Little M P, de Vathaire F, Shamsaldin A, Oberlin O, Campbell S, Grimaud E, Chavaudra J, Haylock R G, Muirhead C R
National Radiological Protection Board, Chilton, Didcot, Oxon, UK.
Int J Cancer. 1998 Oct 29;78(3):269-75. doi: 10.1002/(SICI)1097-0215(19981029)78:3<269::AID-IJC1>3.0.CO;2-T.
A cohort of 4,400 persons treated for various cancers of childhood in France and the UK was followed up over an extended period to assess risks of subsequent brain tumour in relation to the radiotherapy and chemotherapy that the children received for their first cancer. Elevated risks of subsequent brain tumours were associated with first central nervous system (CNS) tumour (two-sided p = 0.0002) and neurofibromatosis (two-sided p = 0.001). There was also elevated brain tumour risk (two-sided p = 0.003) associated with ionising radiation exposure, the risk being concentrated among benign and unspecified brain tumours. The radiation-related risk of benign and unspecified brain tumours was significantly higher than that of malignant brain tumours (two-sided p< or =0.05); there was no significant change of malignant brain tumour risk with ionising radiation dose (two-sided p > 0.2). In general, there were no strong associations between alkylating agent dose and brain tumour risk. The only significant association between brain tumour risk and alkylating agent dose was in relation to compounds used (bleomycin, chloraminophen) that are thought not to deliver substantial doses to the brain; the statistical significance of the trend with dose depended on a single case, and thus must be considered a weak result.
对法国和英国4400名接受过儿童期各种癌症治疗的患者进行了长期随访，以评估儿童因首次患癌接受放疗和化疗后发生后续脑肿瘤的风险。后续脑肿瘤风险升高与首次中枢神经系统（CNS）肿瘤（双侧p = 0.0002）和神经纤维瘤病（双侧p = 0.001）有关。电离辐射暴露也与脑肿瘤风险升高有关（双侧p = 0.003），该风险集中在良性和未明确类型的脑肿瘤中。良性和未明确类型脑肿瘤的辐射相关风险显著高于恶性脑肿瘤（双侧p≤0.05）；恶性脑肿瘤风险随电离辐射剂量无显著变化（双侧p > 0.2）。总体而言，烷化剂剂量与脑肿瘤风险之间没有很强的关联。脑肿瘤风险与烷化剂剂量之间唯一显著的关联与认为不会向脑部输送大量剂量的化合物（博来霉素、氯胺苯醇）有关；剂量趋势的统计学显著性取决于单个病例，因此必须视为一个较弱的结果。
