Ng J, Shuryak I, et al.
Cancer management and research. Date of publication 2014 Dec 17;volume 7():1-11.
1. Cancer Manag Res. 2014 Dec 17;7:1-11. doi: 10.2147/CMAR.S47220. eCollection 2015.
Minimizing second cancer risk following radiotherapy: current perspectives.
Ng J(1), Shuryak I(2).
Author information:
(1)Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY,
USA.
(2)Center for Radiologic Research, Columbia University Medical Center, New York,
NY, USA.
Secondary cancer risk following radiotherapy is an increasingly important topic
in clinical oncology with impact on treatment decision making and on patient
management. Much of the evidence that underlies our understanding of secondary
cancer risks and our risk estimates are derived from large epidemiologic studies
and predictive models of earlier decades with large uncertainties. The modern era
is characterized by more conformal radiotherapy technologies, molecular and
genetic marker approaches, genome-wide studies and risk stratifications, and
sophisticated biologically based predictive models of the carcinogenesis process.
Four key areas that have strong evidence toward affecting secondary cancer risks
are 1) the patient age at time of radiation treatment, 2) genetic risk factors,
3) the organ and tissue site receiving radiation, and 4) the dose and volume of
tissue being irradiated by a particular radiation technology. This review
attempts to summarize our current understanding on the impact on secondary cancer
risks for each of these known risk factors. We review the recent advances in
genetic studies and carcinogenesis models that are providing insight into the
biologic processes that occur from tissue irradiation to the development of a
secondary malignancy. Finally, we discuss current approaches toward minimizing
the risk of radiation-associated secondary malignancies, an important goal of
clinical radiation oncology.
DOI: 10.2147/CMAR.S47220
PMCID: PMC4274043
PMID: 25565886
