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description Publicationkeyboard_double_arrow_right Article 2021 Czech Republic, GermanySpringer Science and Business Media LLC Cristoforo Simonetto; Daniel Wollschläger; Pavel Kundrát; Alexander Ulanowski; Janine Becker; Noemi Castelletti; Denise Güthlin; Elena Shemiakina; Markus Eidemüller;In breast cancer radiotherapy, substantial radiation exposure of organs other than the treated breast cannot be avoided, potentially inducing second primary cancer or heart disease. While distant organs and large parts of nearby ones receive doses in the mGy–Gy range, small parts of the heart, lung and bone marrow often receive doses as high as 50 Gy. Contemporary treatment planning allows for considerable flexibility in the distribution of this exposure. To optimise treatment with regards to long-term health risks, evidence-based risk estimates are required for the entire broad range of exposures. Here, we thus propose an approach that combines data from medical and epidemiological studies with different exposure conditions. Approximating cancer induction as a local process, we estimate organ cancer risks by integrating organ-specific dose–response relationships over the organ dose distributions. For highly exposed organ parts, specific high-dose risk models based on studies with medical exposure are applied. For organs or their parts receiving relatively low doses, established dose–response models based on radiation-epidemiological data are used. Joining the models in the intermediate dose range leads to a combined, in general non-linear, dose response supported by data over the whole relevant dose range. For heart diseases, a linear model consistent with high- and low-dose studies is presented. The resulting estimates of long-term health risks are largely compatible with rate ratios observed in randomised breast cancer radiotherapy trials. The risk models have been implemented in a software tool PASSOS that estimates long-term risks for individual breast cancer patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00411-021-00924-8.
Europe PubMed Centra... arrow_drop_down Publication Server of Helmholtz Zentrum München (PuSH)Article . 2021Data sources: Publication Server of Helmholtz Zentrum München (PuSH)Repository of the Czech Academy of SciencesArticle . 2021Data sources: Repository of the Czech Academy of Sciencesadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1007/s00411-021-00924-8&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu5 citations 5 popularity Top 10% influence Average impulse Average Powered by BIP!
more_vert Europe PubMed Centra... arrow_drop_down Publication Server of Helmholtz Zentrum München (PuSH)Article . 2021Data sources: Publication Server of Helmholtz Zentrum München (PuSH)Repository of the Czech Academy of SciencesArticle . 2021Data sources: Repository of the Czech Academy of Sciencesadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1007/s00411-021-00924-8&type=result"></script>'); --> </script>
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description Publicationkeyboard_double_arrow_right Article 2021 Czech Republic, GermanySpringer Science and Business Media LLC Cristoforo Simonetto; Daniel Wollschläger; Pavel Kundrát; Alexander Ulanowski; Janine Becker; Noemi Castelletti; Denise Güthlin; Elena Shemiakina; Markus Eidemüller;In breast cancer radiotherapy, substantial radiation exposure of organs other than the treated breast cannot be avoided, potentially inducing second primary cancer or heart disease. While distant organs and large parts of nearby ones receive doses in the mGy–Gy range, small parts of the heart, lung and bone marrow often receive doses as high as 50 Gy. Contemporary treatment planning allows for considerable flexibility in the distribution of this exposure. To optimise treatment with regards to long-term health risks, evidence-based risk estimates are required for the entire broad range of exposures. Here, we thus propose an approach that combines data from medical and epidemiological studies with different exposure conditions. Approximating cancer induction as a local process, we estimate organ cancer risks by integrating organ-specific dose–response relationships over the organ dose distributions. For highly exposed organ parts, specific high-dose risk models based on studies with medical exposure are applied. For organs or their parts receiving relatively low doses, established dose–response models based on radiation-epidemiological data are used. Joining the models in the intermediate dose range leads to a combined, in general non-linear, dose response supported by data over the whole relevant dose range. For heart diseases, a linear model consistent with high- and low-dose studies is presented. The resulting estimates of long-term health risks are largely compatible with rate ratios observed in randomised breast cancer radiotherapy trials. The risk models have been implemented in a software tool PASSOS that estimates long-term risks for individual breast cancer patients. Supplementary Information The online version contains supplementary material available at 10.1007/s00411-021-00924-8.
Europe PubMed Centra... arrow_drop_down Publication Server of Helmholtz Zentrum München (PuSH)Article . 2021Data sources: Publication Server of Helmholtz Zentrum München (PuSH)Repository of the Czech Academy of SciencesArticle . 2021Data sources: Repository of the Czech Academy of Sciencesadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1007/s00411-021-00924-8&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu5 citations 5 popularity Top 10% influence Average impulse Average Powered by BIP!
more_vert Europe PubMed Centra... arrow_drop_down Publication Server of Helmholtz Zentrum München (PuSH)Article . 2021Data sources: Publication Server of Helmholtz Zentrum München (PuSH)Repository of the Czech Academy of SciencesArticle . 2021Data sources: Repository of the Czech Academy of Sciencesadd ClaimPlease grant OpenAIRE to access and update your ORCID works.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.This Research product is the result of merged Research products in OpenAIRE.
You have already added works in your ORCID record related to the merged Research product.All Research productsarrow_drop_down <script type="text/javascript"> <!-- document.write('<div id="oa_widget"></div>'); document.write('<script type="text/javascript" src="https://www.openaire.eu/index.php?option=com_openaire&view=widget&format=raw&projectId=10.1007/s00411-021-00924-8&type=result"></script>'); --> </script>
For further information contact us at helpdesk@openaire.eu