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Additional info for Second Primary Cancers and Cardiovascular Disease After Radiation Therapy
Example text
Statistical tests are available for assessing differences and trends in the relative risk (or ERR Gy –1). Another issue that can be addressed in studies with adequate data are the interaction of RT with other risk factors such as chemotherapy and smoking. Suppose that RRRT is the relative risk associated with RT, that RRother is the relative risk associated with some other factor, and that RRboth is the relative risk associated with both exposures. If RRboth = RRRT × RRother , then the interaction is said to be multiplicative, whereas if RRboth = RRRT + RRother – 1, then the interaction is said to be additive.
The logistic model above can be generalized to allow for this possibility as follows: RR = e ( Σi αi xi ) ( 1 + Σi βi z i ) . 1) If zi is radiation dose, then β i is the ERR per unit of dose (often expressed in gray). The use of this model allows comparison of radiation risk coefficients with those from the many other studies based on linear relative-risk models. It also allows evaluation of whether or not the dose response is adequately described by a linear function. The model above includes the possibility of a linearquadratic function, by taking z1 = dose; z2 = dose2.
ACS, 2009), as described elsewhere in this Report. Some of these agents have been evaluated for their ability to interact with radiation in the induction of transformation in vitro (Kennedy, 1995), and several different types of interactions have been observed, including additive effects (as expected for cocarcinogens) as well as suppressive effects on radiation transformation in vitro. Cancer patients may also be taking other drugs that are likely to have an effect on the development of cancer, and these drugs could be having either an enhancing or suppressing effect on the development of a radiation-induced SPC.
