• Title/Summary/Keyword: secondary cancer risk

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Clinical Risk Evaluation Using Dose Verification Program of Brachytherapy for Cervical Cancer (자궁경부암 근접치료 시 선량 검증 프로그램을 통한 임상적 위험성 평가)

  • Dong‑Jin, Kang;Young‑Joo, Shin;Jin-Kyu, Kang;Jae‑Yong, Jung;Woo-jin, Lee;Tae-Seong, Baek;Boram, Lee
    • Journal of radiological science and technology
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    • v.45 no.6
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    • pp.553-560
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    • 2022
  • The purpose of this study is to evaluate the clinical risk according to the applicator heterogeneity, mislocation, and tissue heterogeneity correction through a dose verification program during brachytherapy of cervical cancer. We performed image processing with MATLAB on images acquired with CT simulator. The source was modeled and stochiometric calibration and Monte-Carlo algorithm were applied based on dwell time and location to calculate the dose, and the secondary cancer risk was evaluated in the dose verification program. The result calculated by correcting for applicator and tissue heterogeneity showed a maximum dose of about 25% higher. In the bladder, the difference in excess absolute risk according to the heterogeneity correction was not significant. In the rectum, the difference in excess absolute risk was lower than that calculated by correcting applicator and tissue heterogeneity compared to the water-based calculation. In the femur, the water-based calculation result was the lowest, and the result calculated by correcting the applicator and tissue heterogeneity was 10% higher. A maximum of 14% dose difference occurred when the applicator mislocation was 20 mm in the Z-axis. In a future study, it is expected that a system that can independently verify the treatment plan can be developed by automating the interface between the treatment planning system and the dose verification program.

A Cancer Risk Assessment of Di (2- ethylhexyl ) -phthalate - Application of MOE (Margin of Exposure) Approach (Di(2-ethylhexyl)phthalate의 발암위해성평가 - MOE(Margin of Exposure) 방법론의 활용 -)

  • 최시내;이효민;윤은경;서경원;김효정;박종세
    • Toxicological Research
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    • v.18 no.1
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    • pp.99-106
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    • 2002
  • The United States Environmental Protection Agency (EPA) characterized the cancer hazard of di(2-ethylhexyl)-phthalate (DEHP) as a B2 group (probable human carcinogen) and proposed "Guide-lines for Carcinogen Risk Assessment". This guidelines proposed alternative methods for analyzing carcinogen dose-response data and for extrapolating the effects of observed at high dose to predict that might occur at lower doses relevant to human exposure. This proposed guidelines state that "If in a particular case, the evidence indicated a threshold, as in the case of carcinogenicity being secondary to another toxicity that has a threshold, the margin of exposure analysis for toxicity is the same as is done for a non-cancer endpoint". DEHP is excellent candidate for reconideration under the new guidelines for carcinogen risk assessment (John Doull et al., 1998). This study is conducted about risk assessment for infant exposure on DEHP in powdered milk wing methodology in EPA's new guideline on carcinogenic risk assessment. Estimated cancer risk of DEHP in powdered milk and cow milk is 2.83$\times$$10^5$ (using cancer potency: 1.4$\times$$10^2$/ (mg/kg/day)) as mean and MOE is 12075 (using selected NOEL 20 mg/kg/day) as mean. mg/kg/day) as mean.

Estimated Risk of Radiation Induced Contra Lateral Breast Cancer Following Chest Wall Irradiation by Conformal Wedge Field and Forward Intensity Modulated Radiotherapy Technique for Post-Mastectomy Breast Cancer Patients

  • Athiyaman, Hemalatha;M, Athiyaman;Chougule, Arun;Kumar, HS
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.12
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    • pp.5107-5111
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    • 2016
  • Background: Epidemiological studies have indicated an increasing incidence of radiation induced secondary cancer (SC) in breast cancer patients after radiotherapy (RT), most commonly in the contra-lateral breast (CLB). The present study was conducted to estimate the SC risk in the CLB following 3D conformal radiotherapy techniques (3DCRT) including wedge field and forward intensity modulated radiotherapy (fIMRT) based on the organ equivalent dose (OED). Material and Methods: RT plans treating the chest wall with conformal wedge field and fIMRT plans were created for 30 breast cancer patients. The risks of radiation induced cancer were estimated for the CLB using dose-response models: a linear model, a linear-plateau model and a bell-shaped model with full dose response accounting for fractionated RT on the basis of OED. Results: The plans were found to be ranked quite differently according to the choice of model; calculations based on a linear dose response model fIMRT predict statistically significant lower risk compared to the enhanced dynamic wedge (EDW) technique (p-0.0089) and a non-significant difference between fIMRT and physical wedge (PW) techniques (p-0.054). The widely used plateau dose response model based estimation showed significantly lower SC risk associated with fIMRT technique compared to both wedge field techniques (fIMRT vs EDW p-0.013, fIMRT vs PW p-0.04). The full dose response model showed a non-significant difference between all three techniques in the view of second CLB cancer. Finally the bell shaped model predicted interestingly that PW is associated with significantly higher risk compared to both fIMRT and EDW techniques (fIMRT vs PW p-0.0003, EDW vs PW p-0.0032). Conclusion: In conclusion, the SC risk estimations of the CLB revealed that there is a clear relation between risk associated with wedge field and fIMRT technique depending on the choice of model selected for risk comparison.

Prediction of Promiscuous Epitopes in the E6 Protein of Three High Risk Human Papilloma Viruses: A Computational Approach

  • Nirmala, Subramanian;Sudandiradoss, Chinnappan
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4167-4175
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    • 2013
  • A najor current challenge and constraint in cervical cancer research is the development of vaccines against human papilloma virus (HPV) epitopes. Although many studies are done on epitope identification on HPVs, no computational work has been carried out for high risk forms which are considered to cause cervical cancer. Of all the high risk HPVs, HPV 16, HPV 18 and HPV 45 are responsible for 94% of cervical cancers in women worldwide. In this work, we computationally predicted the promiscuous epitopes among the E6 proteins of high risk HPVs. We identified the conserved residues, HLA class I, HLA class II and B-cell epitopes along with their corresponding secondary structure conformations. We used extremely precise bioinformatics tools like ClustalW2, MAPPP, NetMHC, Epi,Jen, EpiTop 1.0, ABCpred, BCpred and PSIPred for achieving this task. Our study identified specific regions 'FAFR(K)DL' followed by 'KLPD(Q)LCTEL' fragments which proved to be promiscuous epitopes present in both human leukocyte antigen (HLA) class I, class II molecules and B cells as well. These fragments also follow every suitable character to be considered as promiscuous epitopes with supporting evidences of previously reported experimental results. Thus, we conclude that these regions should be considered as the important for design of specific therapeutic vaccines for cervical cancer.

CNS Involvement in the Non-Hodgkin's Lymphoma (중추신경계 악성임파종)

  • Suh, Chang Ok;Kim, Gwi Eon;Park, Chang Yun;Kim, Byung Soo
    • Radiation Oncology Journal
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    • v.1 no.1
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    • pp.61-67
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    • 1983
  • Two cases of primary malignant lymphoma of the brain and six cases of secondary CNS lymphoma seen at Yonsei cancer center, radiotherapy department for recent 4 years are presented. Primary lymphomas revealed single tumor mass on corpus callosum area and secondary lymphoma were intracranial (3 cases) or leptomeningeal type (3 cases). Histology of primary lymphoma were reticulum cell sarcoma and secondary lymphomas were either diffuse histiocytic or diffuse poorly differentiated lymphocytic lymphoma. All patients showed good response to radiation. Two patients with primary CNS lymphoma and two of six secondary CNS lymphoma are alive after radiotherapy (34, 31, 26, 12 months). But the prognosis of secondary CNS lymphoma is grave, because of progressive systemic disease. Incidence, risk factors, diagnosis and therapeutic management of CNS involvement are also discussed.

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Current Evidence for a Paradigm Shift in Gastric Cancer Prevention From Endoscopic Screening to Helicobacter pylori Eradication in Korea

  • Kim, Young-Il;Choi, Il Ju
    • Journal of Gastric Cancer
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    • v.22 no.3
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    • pp.169-183
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    • 2022
  • Gastric cancer is prevalent in Korea and ranked as the third most common cancer in 2019, followed by lung and thyroid cancers. The National Cancer Screening Program (NCSP) for gastric cancer has been implemented in adults aged ≥ 40 since 1999 and involves endoscopic screening every 2 years. The beneficial effects of the current NCSP on early cancer detection, cost-effectiveness, and mortality reduction are evident. However, the screening program results in a large socioeconomic burden and the consumption of medical resources, as it focuses solely on secondary prevention (early detection) rather than primary prevention of cancer. Helicobacter pylori is defined as a group I carcinogen by the International Agency for Research on Cancer. Hence, its eradication has been suggested as an important primary gastric cancer prevention strategy. Well-designed randomized controlled trials involving high-risk groups (post-endoscopic resection of early gastric cancer and family history of gastric cancer) and long-term follow-up studies in the general population have provided high-quality evidence regarding the effects of H. pylori eradication on gastric cancer prevention. In this review, we discussed the evidences for a possible modification of the current gastric cancer secondary prevention strategy by introducing primary prevention through H. pylori eradication. Areas for future research to optimize primary prevention strategies were also suggested.

Risk of Death and Occurrence of Secondary Disease of Cancer and Cardiovascular Disease Patient by Income Level in Korea (암, 심뇌혈관 질환자의 소득수준에 따른 사망 및 이차 질환 발생 위험)

  • Kang, Minjin;Son, Kangju
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.145-157
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    • 2018
  • In this study, we analyzed the effect of the income level of cancer, stroke, and myocardial infarction on mortality by using National Health Insurance Service(NHIS) Cohort 2.0 DB. Patients who newly developed the disease in 2007 were observed till 2015. The analysis used the Cox probability proportional risk model and the competing risk model. The income level used information at the time of the onset of the disease in 2007, categorized into low / mid / high. The results showed that there were differences in the risks of death and secondary disease in patients with cancer, stroke, or myocardial infarction according to the income level. In addition to the need for a social safety net to lower the incidence of early deaths in low-income families, it seems necessary to continue to strengthen universal protection for serious diseases similar to the current policy.

Gastric Cancer in Asian American Populations: a Neglected Health Disparity

  • Taylor, Victoria M.;Ko, Linda K.;Hwang, Joo Ha;Sin, Mo-Kyung;Inadomi, John M.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10565-10571
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    • 2015
  • Gastric cancer incidence rates vary dramatically by world region with East Asia having the highest rate. The Asian population of the United States (US) is growing rapidly and over 17 million Americans are of Asian descent. A majority of Chinese, Korean and Vietnamese Americans are immigrants. Americans of East and Southeast Asian descent experience marked gastric cancer disparities and the incidence rate among Korean men in the US is over five times higher than the incidence rate among non-Hispanic white men. Randomized controlled trials have provided evidence for the effectiveness of helicobacter pylori identification and eradication in preventing gastric cancer. Additionally, Japan and South Korea have both experienced improvements in gastric cancer mortality following the implementation of programs to detect early stage gastric cancers. There are currently no clear US guidelines regarding the primary and secondary prevention of gastric cancer in high-risk immigrant populations. However, it is likely that a proportion of US physicians are already recommending gastric cancer screening for Asian patients and some Asian immigrants to the US may be completing screening for gastric cancer in their native countries. Surveys of US primary care physicians and Asian American communities should be conducted to assess current provider practices and patient uptake with respect to gastric cancer prevention and control. In the absence of clinical guidelines, US health care providers who serve high-risk Asian groups could consider a shared decision-making approach to helicobacter pylori identification and eradication, as well as gastric endoscopy.

A review of analysis methods for secondary outcomes in case-control studies

  • Schifano, Elizabeth D.
    • Communications for Statistical Applications and Methods
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    • v.26 no.2
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    • pp.103-129
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    • 2019
  • The main goal of a case-control study is to learn the association between various risk factors and a primary outcome (e.g., disease status). Particularly recently, it is also quite common to perform secondary analyses of the case-control data in order to understand certain associations between the risk factors of the primary outcome. It has been repeatedly documented with case-control data, association studies of the risk factors that ignore the case-control sampling scheme can produce highly biased estimates of the population effects. In this article, we review the issues of the naive secondary analyses that do not account for the biased sampling scheme, and also the various methods that have been proposed to account for the case-control ascertainment. We additionally compare the results of many of the discussed methods in an example examining the association of a particular genetic variant with smoking behavior, where the data were obtained from a lung cancer case-control study.

Development of an Integrated Breast Health Program for Prevention of Breast Cancer among Middle-aged Women (중년 여성의 유방암 예방을 위한 통합적 유방건강 프로그램 개발)

  • Hur, Hea-Kyung;Park, So-Mi;Kim, Chang-Hee;Park, Jong-Ku;Koh, Sang-Baek;Kim, Gi-Yon
    • Women's Health Nursing
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    • v.15 no.1
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    • pp.54-63
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    • 2009
  • Purpose: This study was done to develop an integrated breast health program for prevention and early detection of breast cancer, integrating primary and secondary prevention factors using cognitive-behavioral strategies. Method: This methodological study conducted as follows; Selection of components for the program through a literature review, survey to identify women's knowledge and risk perception of breast cancer and diet, and building prototype for the program using discussion based on findings. Using structured questionnaires, interviews were done with 130 women aged 40-59 who lived in a rural area. Result: Primary prevention (diet pattern, knowledge about breast cancer, and risk perception) and secondary prevention (early detection behaviors) factors were identified through the literature review. The survey showed that women lack knowledge and awareness about the risks of breast cancer, and have a low compliance rate for early detection behavior. Based on these results, a program was developed utilizing counseling and models to provide education and practice related to diet, breast cancer, and early detection behaviors. Conclusion: Use of this integrated and tailored breast health program with women at risk will contribute to better breast health, but further study is needed to verify the effects.

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