DOE OSTI2014
Because of its effectiveness in causing lethal damage to cancer cells and yielding local tumor control, radiotherapy is an important component of most curative cancer treatments. In radiotherapy, very high doses of radiation are delivered deliberately to patients, with the goal of conforming a prescribed radiation dose to the clinical target and nearby tissues. In this process, radiation absorbed dose damages organs and tissues both from therapeutic radiation within the treatment fields and stray radiation outside the treatment fields. Stray radiation originates either in the treatment unit or in the patient and has no known therapeutic benefit. Over the past decade, our understanding of these exposures and secondary effects has grown immensely. In this presentation, we will discuss the radiogenic risks in normal tissues of cancer patients receiving radiotherapy, with a particular focus on late effects and what is being done to reduce the risks. Long-term epidemiological studies of patients or others who have been exposed to radiation are essential for understanding the relationship between effective dose and the risk of late effects. However, in the case of epidemiological studies for patients exposed to radiation, many of the techniques used to deliver the radiation (and often the chemotherapy used) are obsolete. The results of these studies are further complicated by the direct or synergistic effects of chemotherapy and variations in genetic susceptibility, which are very difficult to take into account or control statistically. This underscores the value of predictive dosimetric studies that rely on risk models and can be done immediately without the need for long-term follow up, for example in silico clinical trials. In this presentation, we will discuss more comprehensively the risks of radiogenic late effects, specifically with regard to cancer patients receiving radiotherapy, including recent epidemiological and predictive dosimetric studies. Methods of reducing these risks will also be presented. (author)
61 RADIATION PROTECTION AND DOSIMETRY↗