Thyroid Radiation Dose and Other Risk Factors of Thyroid Carcinoma Following Childhood Cancer.
BACKGROUND
Thyroid carcinoma is a frequent complication of childhood cancer radiotherapy. The dose response to thyroid radiation dose is now well established, but the potential modifier effect of other factors requires additional investigation.


OBJECTIVE
This study aimed to investigate the role of potential modifiers of the dose response.


METHODS
We followed a cohort of 4338 5-year survivors of solid childhood cancer treated before 1986 over an average of 27 years. The dose received by the thyroid gland and some other anatomical sites during radiotherapy was estimated after reconstruction of the actual conditions in which irradiation was delivered.


RESULTS
Fifty-five patients developed thyroid carcinoma. The risk of thyroid carcinoma increased with a radiation dose to the thyroid of up to two tenths of Gy, then leveled off for higher doses. When taking into account the thyroid radiation dose, a surgical or radiological splenectomy (>20 Gy to the spleen) increased thyroid cancer risk (relative risk [RR] = 2.3; 95% confidence interval [CI], 1.3-4.0), high radiation doses (>5 Gy) to pituitary gland lowered this risk (RR = 0.2; 95% CI, 0.1-0.6). Patients who received nitrosourea chemotherapy had a 6.6-fold (95% CI, 2.5-15.7) higher risk than those who did not. The excess RR per Gy of radiation to the thyroid was 4.7 (95% CI, 1.7-22.6). It was 7.6 (95% CI, 1.6-33.3) if body mass index at time of interview was equal or higher than 25 kg/m(2), and 4.1 (95% CI, 0.9-17.7) if not (P for interaction = .1).


CONCLUSIONS
Predicting thyroid cancer risk following childhood cancer radiation therapy probably requires the assessment of more than just the radiation dose to the thyroid. Chemotherapy, splenectomy, radiation dose to pituitary gland, and obesity also play a role.
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Florent
F
de Vathaire
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Nadia
N
Haddy
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Rodrigue S
RS
Allodji
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Mike
M
Hawkins
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Catherine
C
Guibout
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Chiraz
C
El-Fayech
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Cécile
C
Teinturier
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Odile
O
Oberlin
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Hélène
H
Pacquement
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Fara
F
Diop
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Amar
A
Kalhouche
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Mohamedamine
M
Benadjaoud
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
David
D
Winter
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Angela
A
Jackson
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Giao
G
Bezin Mai-Quynh
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Aymen
A
Benabdennebi
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Damien
D
Llanas
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Cristina
C
Veres
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Martine
M
Munzer
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Tan Dat
TD
Nguyen
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Pierre-Yves
PY
Bondiau
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Delphine
D
Berchery
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Anne
A
Laprie
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Eric
E
Deutsch
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Dimitri
D
Lefkopoulos
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Martin
M
Schlumberger
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Ibrahima
I
Diallo
Radiation Epidemiology Group (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., I.D., C.R.), INSERM U1018 Villejuif, F-94805, France; Institut Gustave Roussy (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., D.L., M.S., I.D., C.R.), Villejuif, F-94805, France; Université Paris-Sud (F.d.V., N.H., R.S.A., C.G., C.E.-F., C.T., O.O., F.D., A.K., M.B., A.J., G.B.M.-Q., A.B., D.L., C.V., E.D., M.S., I.D., C.R.), Villejuif, F-94800, France; Centre for Childhood Cancer Survivor Studies, Department of Public Health & Epidemiology (M.H., D.W.), University of Birmingham, Birmingham B15 2TT, United Kingdom; Institut Curie (H.P.), Paris F-75005 Paris, France; Institut Jean Godinot (M.M., T.D.N.), F-51092 Reims, France; Centre Antoine Lacassagne (P.-Y.B.), F-06100 Nice, France; and Centre Claudius Régaud (D.B., A.L.), F-51100 Toulouse, France.
Carole
C
Rubino
D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D009381:Neoplasms, Radiation-Induced / Q000453:epidemiology*; D009607:Nitrosourea Compounds / Q000009:adverse effects; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D010902:Pituitary Gland / Q000528:radiation effects; D011829:Radiation Dosage; D011878:Radiotherapy / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013156:Splenectomy; D013961:Thyroid Gland / Q000528:radiation effects; D013964:Thyroid Neoplasms / Q000453:epidemiology*
D000970:Antineoplastic Agents; D009607:Nitrosourea Compounds