Cumulative Radiation Exposure and Lifetime Cancer Risk in Patients With Tetralogy of Fallot Requiring Early Intervention
Authors' conclusion
Cumulative radiation exposure and LARs were higher among those undergoing SR compared to PR.
Study context
- Population
- Neonates with tetralogy of Fallot and symptomatic cyanosis (sTOF) requiring early intervention, Congenital Cardiac Research Collaborative, 2012–2017
- Participants
- 242 neonates8 centres
- Exposure
- Staged repair vs primary repair
- Staged repair (SR)n = 146
- Primary repair (PR)n = 96reference
- Outcome
- Cumulative radiation exposure (total effective dose) and associated LAR of cancer
- Follow-up
- Prior to 18 months of age
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Cumulative total effective dose
SR
8.3
median · IQR 3.0–17.4 · mSv
PR
2.1
IQR 0.8–8.5 · mSv
P < 0.001
Observational data: associations, not effects.
Further findings
- Lifetime attributable risk (LAR) of breast cancer in females (organs with median exposure >1 mGy) — SR
- mean 1.9 /1,000 patients
- Proportion of thyroid cancers attributable to radiation, females — SR
- 7.3%
- LAR of breast cancer in females (organs with median exposure >1 mGy): highest LAR among organs with median exposure >1 mGy in females
- Proportion of thyroid cancers attributable to radiation, females: highest projected proportion of cancers attributable to radiation
Cumulative organ-level doses
- Significantly higher in SR compared to PR
LAR of cancer by sex
- Regardless of treatment strategy, LARs higher in females than males
Original publication
Cumulative Radiation Exposure and Lifetime Cancer Risk in Patients With Tetralogy of Fallot Requiring Early Intervention. JACC Adv. Published 6 September 2024. doi:10.
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