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Ionizing radiation and the risk of brain and central nervous system tumors: a systematic review

机译：电离辐射与脑和中枢神经系统肿瘤的风险：系统评价

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Although exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for brain and CNS tumors, it is not clear whether this relationship differs across tumor subtypes, by sex or age at exposure, or at the low-to-moderate range of exposure. This systematic review summarizes the epidemiologic evidence on the association between ionizing radiation exposure and risk of brain/CNS tumors. Articles included in this review estimated radiation exposure doses to the brain and reported excess relative risk (ERR) estimates for brain/CNS tumors. Eight cohorts were eligible for inclusion in the analysis. Average age at exposure ranged from 8 months to 26 years. Mean dose to the brain ranged from 0.07 to 10 Gy. Elevated risks for brain/CNS tumors were consistently observed in relation to ionizing radiation exposure, but the strength of this association varied across cohorts. Generally, ionizing radiation was more strongly associated with risk for meningioma compared with glioma. The positive association between ionizing radiation exposure and risk for glioma was stronger for younger vs older ages at exposure. We did not observe an effect modification on the risk for meningioma by sex, age at exposure, time since exposure, or attained age. The etiologic role of ionizing radiation in the development of brain/CNS tumors needs to be clarified further through additional studies that quantify the association between ionizing radiation and risk for brain/CNS tumors at low-to-moderate doses, examine risks across tumor subtypes, and account for potential effect modifiers.
机译：尽管暴露于中至高剂量的电离辐射是脑部和中枢神经系统肿瘤唯一确定的环境危险因素，但尚不清楚这种关系是否会因肿瘤的亚型，暴露的性别或年龄或低暴露而有所不同。 -中等曝光范围。该系统综述总结了电离辐射暴露与脑部/中枢神经系统肿瘤风险之间关系的流行病学证据。这篇综述中的文章估计了对大脑的辐射暴露剂量，并报道了对大脑/ CNS肿瘤的超额相对风险（ERR）估计。八个队列符合纳入分析的条件。接触的平均年龄为8个月至26岁。对大脑的平均剂量为0.07至10 Gy。始终观察到与电离辐射暴露相关的脑部/中枢神经系统肿瘤的风险升高，但是这种关联的强度在不同人群中各不相同。通常，与神经胶质瘤相比，电离辐射与脑膜瘤的风险更密切相关。电离辐射暴露与胶质瘤风险之间的正相关性在暴露时相对于年轻年龄段要大。我们没有观察到按性别，接触年龄，接触时间或到达年龄对脑膜瘤风险的影响。电离辐射在脑部/中枢神经系统肿瘤发展中的病因学作用需要通过其他研究进一步阐明，这些研究对低至中剂量下电离辐射与脑部/中枢神经系统肿瘤风险之间的关联进行定量分析，检查各种肿瘤亚型的风险，并考虑潜在的效果修改器。

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