Pathology study of malignant tumors of soft tissue and bone among A-bomb survivors, 1957-2003

Summary

The excess risk of sarcomas of the soft tissues and bones associated with high therapeutic doses of radiation has been known for some time but epidemiological data on the risk associated with radiation exposure at relatively low doses are very limited. The latest analysis of solid cancer incidence data of the Life Span Study (LSS) cohort of the Radiation Effects Research Foundation (RERF) provided, for the first time in this cohort, evidence of a significant dose response for broadly-classified sarcomas using the tumor registry-based incidence data. We propose to conduct a detailed, standardized pathology review of sarcomas in order to investigate the association between estimated radiation dose (DS02) and risk of sarcomas by histological types and sub-types. Soft-tissue and bone sarcomas occurring between 1957 and 2003 in the LSS cohort will be identified through the Hiroshima and Nagasaki tumor registries and supplemented by additional information based on autopsy and surgical pathology records at RERF and major medical institutions in both cities, and death certificates. A panel of pathologists will review cases of soft-tissue and bone sarcomas as reported to the tumor registries and other sources indicated above together with cases with diagnoses to which soft-tissue and bone sarcomas may have been misclassified. The panel will provide consensus diagnoses by histological types, which will be classified using the World Health Organization (WHO) Classification of Tumours of Soft Tissue and Bone (2002). Analyses will be performed to assess the radiation-related risk of sarcomas using a Poisson regression model and to evaluate modifying effects, if any, of age, gender, and other factors.

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