Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer

Yeo Jin Lee, Yong Eun Chung, Joon Seok Lim, Joo Hee Kim, Young Jin Kim, Hye Jeong Lee, Je Sung You, Myeong Jin Kim, Ki Whang Kim

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Objective: To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. Subjects and Methods: Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. Results: The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62% of all patients received an estimated cED of over 50 mSv, while 11% of patients received over 100 mSv. The median LAR of cancer incidence was 0.28% (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1% in 2.4% of the patients. Conclusion: The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.

Original languageEnglish
Pages (from-to)144-151
Number of pages8
JournalKorean journal of radiology
Volume13
Issue number2
DOIs
Publication statusPublished - 2012 Jan 1

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Stomach Neoplasms
Neoplasms
Radiation Exposure
Incidence
Ionizing Radiation
Radiation
Population

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Lee, Yeo Jin ; Chung, Yong Eun ; Lim, Joon Seok ; Kim, Joo Hee ; Kim, Young Jin ; Lee, Hye Jeong ; You, Je Sung ; Kim, Myeong Jin ; Kim, Ki Whang. / Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer. In: Korean journal of radiology. 2012 ; Vol. 13, No. 2. pp. 144-151.
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title = "Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer",
abstract = "Objective: To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. Subjects and Methods: Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. Results: The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62{\%} of all patients received an estimated cED of over 50 mSv, while 11{\%} of patients received over 100 mSv. The median LAR of cancer incidence was 0.28{\%} (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1{\%} in 2.4{\%} of the patients. Conclusion: The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.",
author = "Lee, {Yeo Jin} and Chung, {Yong Eun} and Lim, {Joon Seok} and Kim, {Joo Hee} and Kim, {Young Jin} and Lee, {Hye Jeong} and You, {Je Sung} and Kim, {Myeong Jin} and Kim, {Ki Whang}",
year = "2012",
month = "1",
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doi = "10.3348/kjr.2012.13.2.144",
language = "English",
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Lee, YJ, Chung, YE, Lim, JS, Kim, JH, Kim, YJ, Lee, HJ, You, JS, Kim, MJ & Kim, KW 2012, 'Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer', Korean journal of radiology, vol. 13, no. 2, pp. 144-151. https://doi.org/10.3348/kjr.2012.13.2.144

Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer. / Lee, Yeo Jin; Chung, Yong Eun; Lim, Joon Seok; Kim, Joo Hee; Kim, Young Jin; Lee, Hye Jeong; You, Je Sung; Kim, Myeong Jin; Kim, Ki Whang.

In: Korean journal of radiology, Vol. 13, No. 2, 01.01.2012, p. 144-151.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Cumulative Radiation exposure during follow-up after curative surgery for gastric cancer

AU - Lee, Yeo Jin

AU - Chung, Yong Eun

AU - Lim, Joon Seok

AU - Kim, Joo Hee

AU - Kim, Young Jin

AU - Lee, Hye Jeong

AU - You, Je Sung

AU - Kim, Myeong Jin

AU - Kim, Ki Whang

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Objective: To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. Subjects and Methods: Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. Results: The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62% of all patients received an estimated cED of over 50 mSv, while 11% of patients received over 100 mSv. The median LAR of cancer incidence was 0.28% (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1% in 2.4% of the patients. Conclusion: The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.

AB - Objective: To quantify the cumulative effective dose (cED) of radiation due to repeated CT and PET/CT examinations after curative resection of gastric cancer and to assess the lifetime attributable risk (LAR) estimates based on Biological Effects of Ionizing Radiation VII models. Subjects and Methods: Patients who underwent a curative resection for gastric cancer between January 2006 and December 2006 and were followed-up until May 2010 were included in this study. The cED was calculated by using the dose-length product values and conversion factors for quantitative risk assessment of radiation exposure. cED and LAR were compared between early and advanced gastric cancer patients and among American Joint Committee on Cancer TNM stage groups (stage I, II, and III). The nonparametric Mann-Whitney U and Kruskal-Wallis tests, followed by a post-hoc analysis with Bonferroni adjustment, were employed as part of the statistical analysis. Results: The overall median cED was 57.8 mSv (interquartile range [IQR], 43.9-74.7). The cED was significantly higher in the advanced (median, 67.0; IQR, 49.1-102.3) than in the early gastric cancer group (median, 52.3; IQR, 41.5-67.9) (p < 0.001), and increased as the TNM stage increased. For radiation exposure, 62% of all patients received an estimated cED of over 50 mSv, while 11% of patients received over 100 mSv. The median LAR of cancer incidence was 0.28% (IQR, 0.20-0.40) and there were significant differences between the early gastric cancer and advanced gastric cancer group (p < 0.001) as well as among the three TNM stage groups (p = 0.015). The LAR of cancer incidence exceeded 1% in 2.4% of the patients. Conclusion: The cED increases proportionally along with tumor stage and, even in early gastric cancer or stage I patients, cED is much higher than that found among the general population. Considering the very good prognosis of early gastric cancer after curative surgery, the cED should be considered when designing a postoperative follow-up CT protocol.

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DO - 10.3348/kjr.2012.13.2.144

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EP - 151

JO - Korean Journal of Radiology

JF - Korean Journal of Radiology

SN - 1229-6929

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