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Program Information

Second Cancers From Radiation Therapy Procedures

S Kry

R Howell

S Kry*, R Howell*, MD Anderson Cancer Ctr., Houston, TX

WE-A-213AB-1 Wednesday 8:00:00 AM - 8:55:00 AM Room: 213AB

Second Cancers are the most common late effect among long-term cancer survivors. Radiation has been a known risk factor for cancer induction based on atomic bomb survivor follow-up. Over the last few decades, there has also been increasing data on second cancers in medically exposed populations, particularly radiotherapy patients. As treatments become more successful and patients survive longer after treatment, long-term patient health considerations must play an increasing role in the selection of treatment. To this end, it is important that the field of medical physics become well educated in issues related to long-term radiotherapy sequelae, including second cancers.

The session chair will give an overview of retrospective dose reconstruction method commonly used in these large cohort studies second cancers in patients treated with radiation therapy. Understanding the dosimetry in these studies will provide a better understanding of the results of the studies, the dose response models, and gaps in knowledge regarding dose volume effects. In the remainder of the presentation, the speaker will focus on the current state of knowledge of second cancers, specifically focusing on information and limitations of the available literature. This will include the magnitude of risk of second cancers, including the impact of different demographics. It will also include etiological discussions, focusing on the risk attributable to radiation. This presentation will include the available data on the dose response of second cancers, including the large uncertainties inherent to both low and high dose regions. It will also highlight dosimetry for advanced radiotherapy techniques, and what associated doses might mean for the second cancer risk. Finally, the presentation will discuss examples of how second cancer risk can be reduced in routine clinical practice.

Learning objectives: increase the knowledge of clinical medical physicists regarding radiation-induced second cancers as well as stimulate further research in this broad and increasingly important area. There are five main learning objectives for this session:
1. To provide general overview of the dose reconstruction methods used in epidemiological retrospective cohort studies of radiation related late effects.
2. To improve the understanding of the magnitude of the second cancer risk faced by radiotherapy patients.
3. To improve the understanding of the etiology of second cancers.
4. To present an overview of current knowledge on dose response for radiation induced second cancers.
5. To discuss the impact of advanced radiotherapy techniques on the risk of second cancers
6. To provide examples of how second cancer risk can be reduced in routine clinical practice.

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