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The risk of secondary cancers in patients treated for prostate carcinoma: an analysis with competition dose response model
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Radiation Physics.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
Umeå University, Faculty of Medicine, Department of Radiation Sciences, Oncology.
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2009 (English)In: IFMBE Proceedings, Berlin: Springer , 2009, 237-240 p.Conference paper (Refereed)
Abstract [en]

The risk for radiation-induced cancers has become increasingly important as patient survival following radiotherapy has increased due to the advent of new methods for early detection and advanced treatment. Attempts have been made to quantify the risk of cancer that may be associated with various treatment approaches, but the accuracy of predictions is rather low due to the influence of many confouding factors. It is the aim of this paper to investigate the impact of dose heterogeneity and inter-patient anatomical heterogeneity that may be encountered in a population of patients undergoing radiotheray and are thought to influence risk predictions. Dose volume histograms from patients treated with radiation for the carcinoma of the prostate have been used to calculate the risk for secondary malignancies using a competition dose-response model previously developed. Biologically-relevant parameters derived from clinical and experimental data have been used for the model. The results suggested that dose heterogeneity plays an important role in predicting the risk for secondary cancer and that it should be taken into account throught the use of dose volume histograms. Consequently, dose-response relationships derived for uniform relationships should be used with care to predict the risk for secondary malignancies in heterogeneously irradiated tissues. Inter-patient differences could lead to considerable uncertainties in the shape of the relationship between predicted risk and average tissue dose, as seen in epidemiological studies. They also lead to rather weak correlations between the risk for secondary malignancies and target volumes. The results stress the importance of taking into account the details of the clinical delivery of dose in radiotherapy plan evaluation or for retrospective analyses of the induction of secondary cancers. Nevertheless, the levels of risks are generally low and they could be regarded as teh price of success for the advances in the radiotherapy of the prostate.

Place, publisher, year, edition, pages
Berlin: Springer , 2009. 237-240 p.
, IFMBE Proceedings, ISSN 1680-0737 ; 25/III
Keyword [en]
Radiation induced cancers, risk estimations, radiation treatment, prostate cancer, heterongeneity
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-35103DOI: 10.1007/978-3-642-03902-7ISBN: 978-3-642-03901-0OAI: diva2:329340
World Congress on Medical Physics and Biomedical Engineering 2009
Available from: 2010-07-09 Created: 2010-07-09 Last updated: 2011-11-15Bibliographically approved

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