Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review

被引:199
作者
Braganza, Melissa Z. [1 ,2 ]
Kitahara, Cari M. [1 ]
de Gonzalez, Amy Berrington [1 ]
Inskip, Peter D. [1 ]
Johnson, Kimberly J. [2 ]
Rajaraman, Preetha [1 ]
机构
[1] NCI, Div Canc Epidemiol & Genet, Rockville, MD 20852 USA
[2] Washington Univ, St Louis, MO USA
基金
美国国家卫生研究院;
关键词
brain cancer; brain tumors; glioma; ionizing radiation; meningioma; ATOMIC-BOMB SURVIVORS; DENTAL X-RAYS; CANCER INCIDENCE; INTRACRANIAL TUMORS; CHILDHOOD-CANCER; SKIN HEMANGIOMA; FOLLOW-UP; EPIDEMIOLOGY; MENINGIOMA; RADIOTHERAPY;
D O I
10.1093/neuonc/nos208
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Although exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for brain and CNS tumors, it is not clear whether this relationship differs across tumor subtypes, by sex or age at exposure, or at the low-to-moderate range of exposure. This systematic review summarizes the epidemiologic evidence on the association between ionizing radiation exposure and risk of brain/CNS tumors. Articles included in this review estimated radiation exposure doses to the brain and reported excess relative risk (ERR) estimates for brain/CNS tumors. Eight cohorts were eligible for inclusion in the analysis. Average age at exposure ranged from 8 months to 26 years. Mean dose to the brain ranged from 0.07 to 10 Gy. Elevated risks for brain/CNS tumors were consistently observed in relation to ionizing radiation exposure, but the strength of this association varied across cohorts. Generally, ionizing radiation was more strongly associated with risk for meningioma compared with glioma. The positive association between ionizing radiation exposure and risk for glioma was stronger for younger vs older ages at exposure. We did not observe an effect modification on the risk for meningioma by sex, age at exposure, time since exposure, or attained age. The etiologic role of ionizing radiation in the development of brain/CNS tumors needs to be clarified further through additional studies that quantify the association between ionizing radiation and risk for brain/CNS tumors at low-to-moderate doses, examine risks across tumor subtypes, and account for potential effect modifiers.
引用
收藏
页码:1316 / 1324
页数:9
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