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• W2897764827 abstract "Background: Low-dose megavoltage or orthovoltage x-rays treatment for painful benign conditions in the locomotor system as arthrosis and chronic tendinopathy is still widespread in Germany, despite the theoretical risk of radiation-induced malignancies. The aim of this study was to investigate the rate of hematological malignancies, i.e. leukemia, non-Hodgkin’s lymphoma, Hodgkin’s disease and myeloma in patients, treated with low dose x-rays. A cohort of 3017 such patients (mean age 67 years, range 20 - 97 years), treated from 1995 -2007 at the General Hospital of Lippe (northern Germany) was analyzed with regard to the risk of hematologic malignancies suspected of emanating from red bone marrow. Therapy was applied on a conventional radiotherapy treatment with 200 kV orthovoltage x-rays in single fraction of 1 Gy to a total dose of 6 Gy in 6 fractions. Depending on the treated region, the absorbed red marrow dose was determined to be almost zero (elbow, hand, knee, foot; n= 1839), intermediate (shoulder; n= 930), and high (mostly trochanteric bursa and hip, occasionally spine and sacroiliac joint; n= 248). The endpoints (hematological malignancies) were searched for by computer linkage with the hospital information system (the General Hospital of Lippe is the only oncological center for more than 350 0000 people). The rate of hematological malignancies has been assigned to the different dose groups. Median follow-up was 8.8 years (range: 0 - 22.7 years). In the zero dose group, the rates for all hematological malignancies, only leukemia, and only leukemia except chronic lymphocytic leukemia were 4 / 1839 (0.8%), 5 / 1839 (0.3%), and 4 / 1839 (0.2%). In the intermediate dose group (n=929), the corresponding values were 11 / 930 (1.2%), 3 / 930 (0.3%), and 2 / 930 (0.2%). In the highest dose group (n=248), corresponding values were 4 / 248 (1.6%), 2 / 248 (0.8%), and 1 / 248 (0.4%). The differences between the dose groups were not significantly different (chi-squared test). No statistical evidence was provided in this cohort that a higher x-ray dose in the red bone marrow increases hematologic malignancies after low-dose radiotherapy of benign disease in middle-aged and older adults. However, in a larger number of patients, the differences between the dosage groups could reach the level of significance. Therefore, the extension of the cohort will be continued." @default.
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• W2897764827 date "2018-11-01" @default.
• W2897764827 modified "2023-10-17" @default.
• W2897764827 title "Risk of Hematological Malignancies in Patients Treated with X-Rays for Benign Lesions in the Locomotor System–A Retrospective Analysis at a Single Institution" @default.
• W2897764827 doi "https://doi.org/10.1016/j.ijrobp.2018.07.1266" @default.
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