The French Coccinelle study: Risk of lympho-hematopoietic malignancies after medical ionizing radiation exposure from cardiac catheterization during childhood

IF 18 Q4 Medicine

Archives of Cardiovascular Diseases Supplements Pub Date : 2023-09-01 DOI:10.1016/j.acvdsp.2023.07.016

E. Rage , S. Hascoët , C. Dauphin , S. Di Filippo , S. Douchin , F. Godart , P. Guérin , P. Helms , C. Karsenty , B. Lefort , P. Mauran , C. Ovaert , J.F. Piéchaud , J.B. Thambo , D. Bonnet

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引用次数: 0

Abstract

Introduction

Cardiac catheterization (CC) has largely improved the diagnosis and treatment of congenital heart disease in children over the last decades, but it leads to exposure to low doses of X-rays. Children have a greater radiation sensitivity, however, little is known about the long-term radiation associated cancer risks.

Objective

This study aims to assess the risk of lympho-hematopoietic malignancies among children diagnosed and/or treated with CC.

Methods

The COCCINELLE cohort includes children from 15 French paediatric cardiology departments who underwent a first CC between 2000–2013, before 16 years old. The cohort was linked with national registries to identify cancer cases and collect information on predisposing factors to cancer (PF). Individual cumulative doses to active bone marrow (ABM) were calculated with the PCXMC software, based on detailed dosimetric information retrieved from reports of 1,139 CC procedures. Standardised incidence ratios (SIRs) and relative risks (RR) of haematological malignancies associated with the 2-year lagged ABM dose were calculated.

Results/Expected results

The cohort included 17,104 children, followed 6.5 years on average. 22,227 CC procedures were collected, with a mean individual ABM cumulative dose of 3.0 mGy. 38 lympho-hematopoietic malignancies were counted (23 lymphoma and 15 leukemia). A significant excess of cancer incidence was observed (SIR = 3.8 [95% confidence interval 2.9; 4.9]), which wasn’t anymore observed after excluding patients with PF (SIR = 1.3 [0.6; 2.7]). The ABM dose wasn’t significantly associated with the risk of lympho-hematopoietic malignancies (RR/mGy = 1.00 [0.88; 1.10]) or lymphoma (RR/mGy = 1.03 [0.90; 1.14]) after adjustment for attained age, gender and PF.

Conclusion/Perspectives

No significant increase of cancer incidence was observed after excluding patients with PF and no dose-response relationship was observed between the risk of lympho-hematopoietic malignancies or lymphoma and cumulative ABM dose arising from CC procedure. The extension of the COCCINELLE study and the European Harmonic project will help to better assess health effects of CC exposure during childhood.

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法国Coccinelle研究：儿童期心导管插入术电离辐射暴露后淋巴造血系统恶性肿瘤的风险

导读:在过去的几十年里，心导管(CC)在很大程度上改善了儿童先天性心脏病的诊断和治疗，但它会导致暴露在低剂量的x射线下。儿童对辐射更敏感，然而，人们对长期辐射相关的癌症风险知之甚少。本研究旨在评估诊断和/或接受CC治疗的儿童淋巴-造血系统恶性肿瘤的风险。方法COCCINELLE队列包括来自法国15个儿科心脏病科的儿童，他们在2000-2013年期间接受了第一次CC，年龄在16岁之前。该队列与国家登记处相关联，以确定癌症病例并收集有关癌症易感因素(PF)的信息。根据从1139例CC手术报告中检索到的详细剂量学信息，用PCXMC软件计算活性骨髓的个体累积剂量(ABM)。计算血液学恶性肿瘤的标准化发病率(SIRs)和相对危险度(RR)与滞后2年ABM剂量相关。结果/预期结果该队列包括17104名儿童，平均随访6.5年。收集了22,227例CC手术，平均个体ABM累积剂量为3.0 mGy。淋巴-造血系统恶性肿瘤38例(淋巴瘤23例，白血病15例)。癌症发病率显著增加(SIR = 3.8[95%可信区间2.9;4.9])，排除PF患者后不再观察到(SIR = 1.3 [0.6;2.7])。ABM剂量与淋巴-造血系统恶性肿瘤风险无显著相关性(RR/mGy = 1.00 [0.88;1.10])或淋巴瘤(RR/mGy = 1.03 [0.90;[14]在排除PF患者后，未观察到癌症发病率的显著增加，淋巴-造血恶性肿瘤或淋巴瘤的风险与CC手术引起的累积ABM剂量之间未观察到剂量-反应关系。延长COCCINELLE研究和欧洲和声项目将有助于更好地评估儿童时期接触CC对健康的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Cardiovascular Diseases Supplements CARDIAC & CARDIOVASCULAR SYSTEMS-

自引率

0.00%

发文量

508

期刊介绍： Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.