Physics Bucharest 2017
Position of RT induced 2 nd tumors relative to HIGH DOSE AREA
Various primary tumors:
Prostate : increased risk relative to surgery, for 10 y fu: bladder (ERR=77%), rectum (105%), in-field sarcomas (217%), and lung (42%) (Brenner et al. 2000)
Breast : compared to no RT: contralateral breast (ERR=18%), soft-tissue sarcoma (134%), lung (61%), oesophagus (106%), leukemia (71%) (EBCTCG, Lancet 2005)
Breast : compared to no RT: ERR= 45% for sites with D>1Gy (lung, oesophagus, pleura, bone, soft tissue), ERR=9% for contralateral breast ca (D≈1Gy), no evidence for enhanced risk for D<1 Gy (Berrington de Gonzalez et al. 2010)
Clinical data
Cervix : compared to general population: for all latency periods ERR(D>3Gy) > ERR(1Gy
Several sites : 85%: D 3 Gy (Dörr and Herrmann, 2002)
Relatively few secondary solid cancers for very low doses
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