Cancer and mortality risks of patients with scoliosis from radiation exposure: a systematic review and meta-analysis
- PDF / 1,583,729 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 110 Downloads / 209 Views
REVIEW ARTICLE
Cancer and mortality risks of patients with scoliosis from radiation exposure: a systematic review and meta‑analysis Fu‑Jun Luan1 · Yi Wan2 · Kin‑Cheung Mak3 · Chi‑Jiao Ma4 · Hai‑Qiang Wang5 Received: 26 May 2020 / Revised: 12 July 2020 / Accepted: 16 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The study aimed for unraveling the long-term health impact of cumulative radiation exposure from full-spine radiographs on children/adolescents with scoliosis. Methods All cohort, case–control or cross-sectional studies about radiation exposure to scoliosis patients with follow-up period as 20 years or more were included. Meta-analyses were performed for outcomes reported in two or more studies. Results A total of 9 eligible studies involving 35,641 participants between 1912 and 1990 fulfilled the inclusion criteria, including 18,873 patients with scoliosis and 16,768 controls as regional matched general population. The average number of full-spine radiographs was 23.13 (range: 0–618) according to 14,512 patients between 1912 and 1990 in five studies. The estimated mean cumulated radiation dose of breast was 11.35 cGy. In comparison with controls, pooled incidence rates of cancer, breast cancer and cancer mortality of patients with scoliosis were statistically significant higher [rate of cancer, odds risk (OR) = 1.46, p 20
Besides breast cancer, only Simony et al. [4] reported the detail numbers of other cancer types, including four patients with endometrial cancers, one case with lymphoma, one patient with glioma.
13
European Spine Journal
Table 3 Number of radiograph and dose of cumulated radiation
Study
Average number of examinations/ patient
Mean estimated radiation dose
Doody 2000 Goldberg 1998 Hoffman 1989
24.70 (0–618) – 41.50 (0–618)
Ronckers 2010
22.90 (0–553)
Simony 2016
16.30 (8–34)
Levy 1994
Women 12 ± 9.70 Men 10 ± 9.10 – –
Breast 10.80 cGy (range 0–170) – Breast 12.80 rad (0–159) Thyroid 6.90 rad Bone marrow 3.30 rad Breast 10.90 cGy Lung 4.10 cGy Thyroid 7.40 cGy Bone marrow 1.00 cGy Cumulative radiation dose per year 2.40–5.60 mSv The highest mean cumulative dose 0.03 Gy (breast or thyroid) – –
Weinstein 2003 Diarbakerli 2017
Table 4 Quality assessment of the included studies Studies
Doody 2000 Goldberg 1998 Hoffman 1989 Ronckers 2010 Simony 2016 Levy 1994 Weinstein 2003 Diarbakerli 2017 Visscher 1988
Selection Representativeness of the exposed cohort
Selection of the nonexposed cohort
Ascertainment of exposure
Comparability ComparabilAbsence of ity of cohorts outcome at start of study on the basis of the design or analysis
Outcome
Total
1 1
1 1
1 1
1 1
0 0
1 1
1 1
1 1
7 (high) 7 (high)
1
1
1
1
0
1
1
1
7 (high)
1
1
1
1
0
1
1
1
7 (high)
1 1 1
1 0 1
1 1 1
1 1 1
0 0 1
1 1 1
1 1 1
1 1 1
7 (high) 6 (moderate) 8 (high)
1
1
1
1
0
1
1
1
7 (high)
1
0
1
1
0
1
1
1
6 (moderate)
Ascertainment of outcome
Followup period
Adequacy of followup
Table 5 Summary of pooled re
Data Loading...
