title: Risk of secondary cancers from scattered radiation during intensity-modulated radiotherapies for hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate and compare the risks of secondary cancers from therapeutic doses received by patients with hepatocellular carcinoma (HCC) during intensity-modulated radiotherapy (IMRT), volumetric arc therapy (VMAT), and tomotherapy (TOMO).
  
  
  METHODS
  Treatments for five patients with hepatocellular carcinoma (HCC) were planned using IMRT, VMAT, and TOMO. Based on the Biological Effects of Ionizing Radiation VII method, the excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) were evaluated from therapeutic doses, which were measured using radiophotoluminescence glass dosimeters (RPLGDs) for each organ inside a humanoid phantom.
  
  
  RESULTS
  The average organ equivalent doses (OEDs) of 5 patients were measured as 0.23, 1.18, 0.91, 0.95, 0.97, 0.24, and 0.20 Gy for the thyroid, lung, stomach, liver, small intestine, prostate (or ovary), and rectum, respectively. From the OED measurements, LAR incidence were calculated as 83, 46, 22, 30, 2 and 6 per 10(4) person for the lung, stomach, normal liver, small intestine, prostate (or ovary), and rectum.
  
  
  CONCLUSIONS
  We estimated the secondary cancer risks at various organs for patients with HCC who received different treatment modalities. We found that HCC treatment is associated with a high secondary cancer risk in the lung and stomach.
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Kwangzoo
authors.initials: K
authors.lastname: Chung
authors.forename: Weon Kuu
authors.initials: WK
authors.lastname: Chung
authors.forename: Sun Hyun
authors.initials: SH
authors.lastname: Bae
authors.forename: Dong Oh
authors.initials: DO
authors.lastname: Shin
authors.forename: Seongeon
authors.initials: S
authors.lastname: Hong
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Sung-Yong
authors.initials: SY
authors.lastname: Park
authors.forename: Chae-Seon
authors.initials: CS
authors.lastname: Hong
authors.forename: Young Kyung
authors.initials: YK
authors.lastname: Lim
authors.forename: Dongho
authors.initials: D
authors.lastname: Shin
authors.forename: Se Byeong
authors.initials: SB
authors.lastname: Lee
authors.forename: Hyun-ho
authors.initials: HH
authors.lastname: Lee
authors.forename: Jiwon
authors.initials: J
authors.lastname: Sung
authors.affiliation: Department of Radiological Science, College of Health Science, Korea University, Jeongneung 3-dong, Seongbuk-gu, Seoul, Korea. radioyoon@gmail.com.
authors.forename: Myonggeun
authors.initials: M
authors.lastname: Yoon
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000209:etiology* / Q000473:pathology; D016609:Neoplasms, Second Primary / Q000209:etiology* / Q000473:pathology; D019047:Phantoms, Imaging; D011379:Prognosis; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*