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
{"title":"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","authors":"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","doi":"10.1016/j.acvdsp.2023.07.016","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p><span>Cardiac catheterization<span><span> (CC) has largely improved the diagnosis and treatment of </span>congenital heart disease in children over the last decades, but it leads to exposure to low doses of X-rays. Children have a greater </span></span>radiation sensitivity, however, little is known about the long-term radiation associated cancer risks.</p></div><div><h3>Objective</h3><p>This study aims to assess the risk of lympho-hematopoietic malignancies among children diagnosed and/or treated with CC.</p></div><div><h3>Methods</h3><p><span>The COCCINELLE cohort includes children from 15 French paediatric cardiology<span> 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 </span></span>haematological malignancies associated with the 2-year lagged ABM dose were calculated.</p></div><div><h3>Results/Expected results</h3><p>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.</p></div><div><h3>Conclusion/Perspectives</h3><p>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.</p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The French Coccinelle study: Risk of lympho-hematopoietic malignancies after medical ionizing radiation exposure from cardiac catheterization during childhood\",\"authors\":\"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\",\"doi\":\"10.1016/j.acvdsp.2023.07.016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p><span>Cardiac catheterization<span><span> (CC) has largely improved the diagnosis and treatment of </span>congenital heart disease in children over the last decades, but it leads to exposure to low doses of X-rays. Children have a greater </span></span>radiation sensitivity, however, little is known about the long-term radiation associated cancer risks.</p></div><div><h3>Objective</h3><p>This study aims to assess the risk of lympho-hematopoietic malignancies among children diagnosed and/or treated with CC.</p></div><div><h3>Methods</h3><p><span>The COCCINELLE cohort includes children from 15 French paediatric cardiology<span> 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 </span></span>haematological malignancies associated with the 2-year lagged ABM dose were calculated.</p></div><div><h3>Results/Expected results</h3><p>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.</p></div><div><h3>Conclusion/Perspectives</h3><p>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. 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The French Coccinelle study: Risk of lympho-hematopoietic malignancies after medical ionizing radiation exposure from cardiac catheterization during childhood
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.
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.
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