Risk of second cancer after ion beam radiotherapy: insights from animal carcinogenesis studies.

Abstract	Purpose: To review recent studies to better understand the risk of second cancer after ion beam radiotherapy and to clarify the importance of animal radiobiology therein. Results: Risk of developing second cancer after radiotherapy is a concern, particularly for survivors of childhood tumors. Ion beam radiotherapy is expected to reduce the risk of second cancer by reducing exposure of normal tissues to radiation. Large uncertainty lies, however, in the choice of relative biological effectiveness (RBE) of high linear energy transfer (LET) radiation (e.g. carbon ions and neutrons) in cancer induction, especially for children. Studies have attempted to predict the risk of second cancer after ion beam radiotherapy based on an assessment of radiation dose, the risk of low LET radiation, and assumptions about RBE. Animal experiments have yielded RBE values for selected tissues, radiation types, and age at the time of irradiation; the results indicate potentially variable RBE which depends on tissues, ages, and dose levels. Animal studies have also attempted to identify genetic alterations in tumors induced by high LET radiation. Conclusions: Estimating the RBE value for cancer induction is important for understanding the risk of second cancer after ion beam radiotherapy. More comprehensive animal radiobiology studies are needed.
Authors	Tatsuhiko Imaoka, Mayumi Nishimura, Kazuhiro Daino, Masaru Takabatake, Hitomi Moriyama, Yukiko Nishimura, Takamitsu Morioka, Yoshiya Shimada, Shizuko Kakinuma
Journal	International journal of radiation biology (Int J Radiat Biol) Vol. 95 Issue 10 Pg. 1431-1440 (10 2019) ISSN: 1362-3095 [Electronic] England
PMID	30495977 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)
Chemical References	Ions
Topics	Animals Carcinogenesis Disease Models, Animal Female Ions (adverse effects) Linear Energy Transfer Mice Neoplasms, Radiation-Induced Neoplasms, Second Primary (etiology) Proton Therapy (methods) Radiobiology (methods) Radiotherapy (adverse effects, methods) Rats Relative Biological Effectiveness Risk Uncertainty

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