[en] Full text of publication follows: Current radiation protection standards of occupationally exposed workers are based on an extrapolation of cancer risks estimates derived from studies of the survivors of atomic bombings in Hiroshima and Nagasaki. In order to confirm these standards, International Agency for Research Cancer coordinated a retrospective cohort study to estimate the risk of cancer death after low-level exposure to gamma-ray, in a worldwide population of 400 000 nuclear industry workers in 15 countries. Methods: The present study is part of the international study and includes about 13,000 French nuclear industry workers of 10 contracting companies and subsidiary companies. This study was restricted to workers who wore a radiation dosimeter or badge. Contracting companies were selected on the basis of at least 100 workers in activity in 1996. A retrospective cohort was constituted. For each worker, we collected data concerning personal identifiers, occupational history, exposure history, vital status and cause of death. In order to guarantee the reliability of dosimetry data, we confronted monthly doses of X and gamma rays obtained from each company with monthly doses obtained from the National Institute of Radio Protection (I.R.S.N.). The cut off date was the 31 December of 2000. An incidence study is running within this cohort. Data relatives to poly-exposures, incident cancers and other pathologies, have being collected through a questionnaire form. Results: A total of 12,690 workers were included in the cohort, 1,457 could not be identified. Among the 11,233 identified workers, 280 deaths were recorded and 36% of them were cancer. Most of the workers were men (96%) and the median age at cut off date was equal to 41 years old. Only 25% of workers were exposed seven years or more. The median cumulative dose was equal to 3.1 mSv and 25% of workers had a cumulative dose superior to 22 mSv. Conclusion: Median cumulative dose was lower than expected as nuclear industry workers of contracting companies are known to be more exposed to radiation than permanent workers (EDF, Cea/Cogema). A longer follow-up of these specific workers should be necessary. (authors)

[en] In order to calculate the doses received by the organs of 530 children treated by radiation for cancer between 1945 and 1969 at the G. Roussy Institute, we have developed a computer program for organ location calculation. To calculate the location of each child's organs of interest at the time of the treatment, only two parameters are necessary; sex and height or sex and age when the height at the time of the treatment is unknown. The algorithm is based on the metric studies of growth known as auxology. Each organ is located by one point representing its center. The model has been checked on 100 healthy children

[en] The effect of a new perfluorochemical emulsion based on F-66E (54%, w/v) which carries, in combination with carbogen, twice as much oxygen as Fluosol-DA 20% was tested on the radiation response of the lip mucosa of unanesthetized mice. Mice were pretreated with 0.015 ml/g of the F-66E emulsion in the presence of carbogen for 1 h prior to and during irradiation. There was a significant increase in the mortality rate following the highest radiation dose in mice given F-66E emulsion plus carbogen. The reactions of lip mucosa of mice given F-66E emulsion and/or carbogen were not significantly different from that of the control group using three end points (average score, mean peak, incidence of mucosal desquamation), but the peak mucosal reaction was delayed. The radiosensitivity of the mouse lip mucosa to Ethrane, an anesthetic gas inhaled with carbogen, was also tested. The reaction of lip mucosa in the anesthetized mice was significantly greater than that of the control group. There was also a significant increase in the mortality rate following the two highest radiation doses

[en] The protocol used at the Institut Gustave-Roussy to treat, with radioiodine, 283 patients with distant metastases from differentiated thyroid carcinoma is described and its results are analyzed in comparison with available data from other series. (Auth.)

[en] Between 1954 and 1983, 7620 patients were treated for breast carcinoma at Institut Gustave Roussy (France). Of these patients, 6919 were followed for at least 1 year. Out of these, 11 presented with sarcomas thought to be induced by irradiation, 2 of which were Steward-Treves Syndrome, and 9 of which were sarcomas within the irradiated fields. All histological slides were reviewed and a comparison with those of breast cancer was done. The sites of these sarcomas were: parietal wall, 1 case; second costal cartilage, 1 case; infraclavicular region, 1 case; supraclavicular region, 2 cases; internal third of the clavicle, 2 cases; axillary region 2 cases; and the internal side of the upper arm (Stewart-Treves syndrome), 2 cases. The median age of these 11 patients at the diagnosis of sarcomas was 65.8 (49-83). The mean latent period was 9.5 years (4-24). Three patients underwent radical mastectomy and nine modified radical mastectomy. Only one patient received chemotherapy. The radiation doses received at the site of the sarcoma were 45 Gy/18 fr. for 10 cases and 90-100 Gy for 1 case (due to overlapping between two fields). The histology was as follows: malignant fibrous histiocytoma, 5 cases; fibrosarcoma, 3 cases; lymphangiosarcoma, 2 cases; and osteochondrosarcoma, 1 case. The median survival following diagnosis of sarcoma was 2.4 years (4 months-9 years). Two patients are still alive: one with recurrence of her breast cancer, the other in complete remission, with 7 and 3 years follow-up, respectively. All other patients died from their sarcomas. The cumulative incidence of sarcoma following irradiation of breast cancer was 0.2% (0.09-0.47) at 10 years. The standardized incidence ratio (SIR) of sarcoma (observed n number-sign of cases (Obs)/expected n number-sign of cases (Exp) computed from the Danish Cancer Registry for the same period) was 1.81 (CI 0.91-3.23)

[en] The effect of internal mammary chain treatment on each type of malignant death-related event was analyzed in 1195 patients with operable breast cancer and histologically involved axillary lymph nodes. A group of 135 patients who had no internal mammary chain treatment was compared with a control group of 1060 patients who were treated by surgery and/or postoperative radiation therapy. In a multivariate analysis taking into account age, clinical size of the tumor, histoprognostic grading, and the number of positive axillary lymph nodes, quantitative interaction tests were used to determine whether the effects of internal mammary chain treatment on each type of malignant event were significantly different for patients with a lateral tumor compared with those with a medial tumor. The authors found that the effects of this treatment on the risks of distant metastases and of secondary breast cancer were not the same for the patients with a medial tumor as for those with a lateral tumor. For the untreated patients with a medial tumor, the risks of distant metastases and second breast cancer were, respectively, 1.6 (P = 0.02) and 2.9 (P = 0.02), compared with the treated patients. Conversely, for women with lateral tumor, no difference between the two treatment groups was observed. Thus, internal mammary chain treatment may improve long-term survival rate in patients with a medial tumor and positive axillary lymph nodes essentially by decreasing the risk of development of distant metastases (mainly brain, distant lymph nodes, multiple simultaneous metastases) and/or a secondary breast cancer

[en] Radiation doses outside the radiotherapy treatment field are of radiation protection interest. Available studies investigating such doses, focused on specific sites, standard target volumes, and a few radiation beams or treatment conditions. We present a software package designed to perform individual dosimetry in retrospective studies. It was developed for a European cohort study of over 4400 patients who were younger than 17 years when treated for a primary solid cancer in childhood at 8 French and UK cancer centres. The methodology adopted by this software enabled the anatomical data for all patients in the cohort who were between a few days to 16 years of age, to be taken into account. It includes the characteristics of all machines used to treat the patients from 1942 to 1992. The absorbed doses are estimated directly in volum% and the lung heterogeneity is considered. Based on actual measurements, all principal sources of scattered radiation, sources of doses to out-of-beam sites, are modelled and introduced. For each patients, absorbed doses to 151 anatomical sites were calculated, according to radiation beam energy with a range of energy from 50 kV to 31 MV for photons and 4 to 32 MeV for electrons. Such a tool can provide dose estimation sufficiently accurate for radiation protection purposes. (author)

[en] Before 1974 about 5000 children were irradiated at the Institut Gustave-Roussy for a skin hemangioma of whom 20% were treated with radium applicators. To evaluate the absorbed doses to these patients at any site, we have developed a software program which permits simulation of the actual patient and treatment conditions. Part of this software is devoted to constructing an Individual Computerized Tomography Anatomy (ICTA) based on real human transverse slices and auxological tables. From the generated phantom, 160 anatomical sites of epidemiological interest are defined and localized according to a Cartesian co-ordinate system. The gamma doses at all sites from Ra-226 applicators are calculated by an algorithm which permits separation of the radiation paths in air, tissue, and lungs. It includes a correction for attenuation and scatters in infinite and semi-infinite mediums. To evaluate the factor φ(r) for these corrections at any distance or position from the applicator, we have modelled the results from several Monte Carlo simulations. In the range of 1 to 10 cm, the φ(r) values obtained from our model showed good agreement with those obtained by published methods. For several cases, the absorbed doses at points in water and patients from radium applicators estimated by this software, were compared to those measured and estimated at the Karolinska Hospital. The results showed good agreement. (author)

[en] Objective: Radiation exposure during childhood is the only well-established risk factor for papillary thyroid carcinoma (PTC). To better define the biologic profile of radiation-induced and sporadic PTC, we compared in these two groups of PTC the expression of cell cycle regulatory proteins and telomere length. Methods: Cell cycle markers (cyclin A, B1, D1, E, and Ki67) were evaluated on 100 PTC specimens (26 radiation-induced and 74 sporadic PTCs). The expression of cell cycle regulators was studied using immunohistochemistry; telomere length heterogeneity was studied using in situ hybridization in a subset of 16 formalin-fixed samples (8 radiation-induced and 8 sporadic PTCs). Results: At multivariate analysis, only cytoplasmic cyclin E staining was over expressed in sporadic cases (P = 0.006). The other cell cycle markers and telomere length did not differ significantly between sporadic PTC and radiation-induced PTC. Conclusions: These markers cannot be used to differentiate radiation-induced from sporadic PTCs. (authors)

[en] The Japanese atomic bomb survivor cancer incidence dataset and data on five groups exposed to radiation for medical reasons in childhood are analysed and evidence found for a reduction in the radiation-induced relative risk of cancers other than leukaemia with increasing time since exposure and age at exposure. The rate of the reductions in relative risk with time since exposure are not significantly different for those exposed in childhood and for those exposed in adulthood, if adjustment is made for the effects on the relative risk of age at exposure. For those irradiated in childhood, there is a statistically significant annual reduction of 5.8% (95% Cl 2.8, 8.9) in excess relative risk, and there are no strong indications of inter-cohort heterogeniety in the speed of reduction of relative risk. After adjustment for the effects of age at exposure, there is a significant annual reduction of 3.6% (95% Cl 1.6, 5.6) in excess relative risk in all age-at-exposure groups. There are significant reductions of 5.2% (95% Cl 3.7, 6.8) in excess relative risk per year of age at exposure. There are statistically significant (P = 0.04) interactions between the exponential adjustments to the excess relative risk for age at exposure and time since exposure in the Japanese data, but no indications (P = 0.38) of such interactions when powers of time since exposure and attained age are used to adjust the excess relative risk, so that the fit of the model with power adjustments is to be preferred to that of the model with exponential adjustments. (author)