Seminars in Radiation Oncology
Volume 20, Issue 1 , Pages 67-78 , January 2010

Secondary Malignancies Across the Age Spectrum

  • Andrea K. Ng, MD, MPH

      Affiliations

    • Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress reprint requests to Andrea K. Ng, MD, MPH, Department of Radiation Oncology, 75 Francis St, ASB1-L2, Boston, MA 02115
  • ,
  • Lisa B. Kenney, MD, MPH

      Affiliations

    • Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Harvard Medical School, Boston, MA
  • ,
  • Ethel S. Gilbert, PhD

      Affiliations

    • Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD
  • ,
  • Lois B. Travis, MD, ScD

      Affiliations

    • Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY

References 

  1. Ries L, Melbert D, Krapcho M. SEER Cancer Statistics Review, 1975-2004. Bethesda, MD: National Cancer Institute; 2007;
  2. Travis L, Rabkin C, Brown L. Cancer survivorship—genetic susceptibility and second primary cancers: Research strategies and recommendations. J Natl Cancer Inst. 2006;98:15–25
  3. Neglia JP, Friedman DL, Yasui Y. Second malignant neoplasms in five-year survivors of childhood cancer: Childhood cancer survivor study. J Natl Cancer Inst. 2001;93:618–629
  4. Curtis R, Freedman D, Ron E. New Malignancies Among Cancer Survivors: SEER Cancer Registries, 1973-2000. NIH publication 05-5302 Bethesda: National Cancer Institute; 2006;
  5. Jenkinson HC, Hawkins MM, Stiller CA. Long-term population-based risks of second malignant neoplasms after childhood cancer in Britain. Br J Cancer. 2004;91:1905–1910
  6. Meadows AT, Friedman DL, Neglia JP. Second neoplasms in survivors of childhood cancer: Findings from the Childhood Cancer Survivor Study cohort. J Clin Oncol. 2009;27:2356–2362
  7. Mertens AC, Yasui Y, Neglia JP. Late mortality experience in five-year survivors of childhood and adolescent cancer: The Childhood Cancer Survivor Study. J Clin Oncol. 2001;19:3163–3172
  8. Moller TR, Garwicz S, Barlow L. Decreasing late mortality among five-year survivors of cancer in childhood and adolescence: A population-based study in the Nordic countries. J Clin Oncol. 2001;19:3173–3181
  9. Cardous-Ubbink MC, Heinen RC, Langeveld NE. Long-term cause-specific mortality among five-year survivors of childhood cancer. Pediatr Blood Cancer. 2004;42:563–573
  10. Neglia JP, Meadows AT, Robison LL. Second neoplasms after acute lymphoblastic leukemia in childhood. N Engl J Med. 1991;325:1330–1336
  11. Loning L, Zimmermann M, Reiter A. Secondary neoplasms subsequent to Berlin-Frankfurt-Münster therapy of acute lymphoblastic leukemia in childhood: Significantly lower risk without cranial radiotherapy. Blood. 2000;95:2770–2775
  12. Bhatia S, Sather HN, Pabustan OB. Low incidence of second neoplasms among children diagnosed with acute lymphoblastic leukemia after 1983. Blood. 2002;99:4257–4264
  13. Hijiya N, Hudson MM, Lensing S. Cumulative incidence of secondary neoplasms as a first event after childhood acute lymphoblastic leukemia. JAMA. 2007;297:1207–1215
  14. Neglia JP, Robison LL, Stovall M. New primary neoplasms of the central nervous system in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2006;98:1528–1537
  15. Walter AW, Hancock ML, Pui CH. Secondary brain tumors in children treated for acute lymphoblastic leukemia at St Jude Children's Research Hospital. J Clin Oncol. 1998;16:3761–3767
  16. Relling MV, Rubnitz JE, Rivera GK. High incidence of secondary brain tumours after radiotherapy and antimetabolites. Lancet. 1999;354:34–39
  17. Hawkins MM, Wilson LM, Stovall MA. Epipodophyllotoxins, alkylating agents, and radiation and risk of secondary leukaemia after childhood cancer. BMJ. 1992;304:951–958
  18. Pui CH, Ribeiro RC, Hancock ML. Acute myeloid leukemia in children treated with epipodophyllotoxins for acute lymphoblastic leukemia. N Engl J Med. 1991;325:1682–1687
  19. Smith SM, Le Beau MM, Huo D. Clinical-cytogenetic associations in 306 patients with therapy-related myelodysplasia and myeloid leukemia: The University of Chicago series. Blood. 2003;102:43–52
  20. Pui CH, Relling MV, Rivera GK. Epipodophyllotoxin-related acute myeloid leukemia: A study of 35 cases. Leukemia. 1995;9:1990–1996
  21. van Leeuwen FE, Chorus AM, van den Belt-Dusebout AW. Leukemia risk following Hodgkin's disease: Relation to cumulative dose of alkylating agents, treatment with teniposide combinations, number of episodes of chemotherapy, and bone marrow damage. J Clin Oncol. 1994;12:1063–1073
  22. Le Deley MC, Vassal G, Taibi A. High cumulative rate of secondary leukemia after continuous etoposide treatment for solid tumors in children and young adults. Pediatr Blood Cancer. 2005;45:25–31
  23. Haddy N, Le Deley MC, Samand A. Role of radiotherapy and chemotherapy in the risk of secondary leukaemia after a solid tumour in childhood. Eur J Cancer. 2006;42:2757–2764
  24. Cavenee WK, Murphree AL, Shull MM. Prediction of familial predisposition to retinoblastoma. N Engl J Med. 1986;314:1201–1207
  25. Kleinerman RA, Tucker MA, Tarone RE. Risk of new cancers after radiotherapy in long-term survivors of retinoblastoma: An extended follow-up. J Clin Oncol. 2005;23:2272–2279
  26. Fletcher O, Easton D, Anderson K. Lifetime risks of common cancers among retinoblastoma survivors. J Natl Cancer Inst. 2004;96:357–363
  27. Marees T, Moll AC, Imhof SM. Risk of second malignancies in survivors of retinoblastoma: More than 40 years of follow-up. J Natl Cancer Inst. 2008;100:1771–1779
  28. Hawkins MM, Wilson LM, Burton HS. Radiotherapy, alkylating agents, and risk of bone cancer after childhood cancer. J Natl Cancer Inst. 1996;88:270–278
  29. Wong FL, Boice JD, Abramson DH. Cancer incidence after retinoblastoma: Radiation dose and sarcoma risk. JAMA. 1997;278:1262–1267
  30. Tucker MA, D'Angio GJ, Boice JD. Bone sarcomas linked to radiotherapy and chemotherapy in children. N Engl J Med. 1987;317:588–593
  31. Kivela T. Trilateral retinoblastoma: A meta-analysis of hereditary retinoblastoma associated with primary ectopic intracranial retinoblastoma. J Clin Oncol. 1999;17:1829–1837
  32. Kleinerman RA, Tucker MA, Abramson DH. Risk of soft tissue sarcomas by individual subtype in survivors of hereditary retinoblastoma. J Natl Cancer Inst. 2007;99:24–31
  33. Constine LS, Tarbell N, Hudson MM. Subsequent malignancies in children treated for Hodgkin's disease: Associations with gender and radiation dose. Int J Radiat Oncol Biol Phys. 2008;72:24–33
  34. Bhatia S, Yasui Y, Robison LL. High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin's disease: Report from the Late Effects Study Group. J Clin Oncol. 2003;21:4386–4394
  35. Sankila R, Garwicz S, Olsen JH. Risk of subsequent malignant neoplasms among 1,641 Hodgkin's disease patients diagnosed in childhood and adolescence: A population-based cohort study in the five Nordic countries (Association of the Nordic Cancer Registries and the Nordic Society of Pediatric Hematology and Oncology). J Clin Oncol. 1996;14:1442–1446
  36. Ng AK, Bernardo MV, Weller E. Second malignancy after Hodgkin disease treated with radiation therapy with or without chemotherapy: Long-term risks and risk factors. Blood. 2002;100:1989–1996
  37. Swerdlow AJ, Barber JA, Hudson GV. Risk of second malignancy after Hodgkin's disease in a collaborative British cohort: The relation to age at treatment. J Clin Oncol. 2000;18:498-450
  38. Green DM, Hyland A, Barcos MP, et al. Second malignant neoplasms after treatment for Hodgkin's disease in childhood or adolescence. J Clin Oncol. 2000;18:1492–1499
  39. Kenney LB, Yasui Y, Inskip PD. Breast cancer after childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Intern Med. 2004;141:590–597
  40. Curtis RE, Metayer C, Rizzo JD. Impact of chronic GVHD therapy on the development of squamous-cell cancers after hematopoietic stem-cell transplantation: An international case-control study. Blood. 2005;105:3802–3811
  41. Mauch P, Ng A, Aleman B. Report from the Rockefeller Foundation Sponsored International Workshop on reducing mortality and improving quality of life in long-term survivors of Hodgkin's disease. Eur J Haematol Suppl. 2005;66:68–76
  42. Travis LB, Hill DA, Dores GM. Breast cancer following radiotherapy and chemotherapy among young women with Hodgkin disease. JAMA. 2003;290:465–475
  43. van Leeuwen FE, Klokman WJ, Stovall M. Roles of radiation dose, chemotherapy, and hormonal factors in breast cancer following Hodgkin's disease. J Natl Cancer Inst. 2003;95:971–980
  44. Guibout C, Adjadj E, Rubino C. Malignant breast tumors after radiotherapy for a first cancer during childhood. J Clin Oncol. 2005;23:197–204
  45. Travis LB, Hill D, Dores GM. Cumulative absolute breast cancer risk for young women treated for Hodgkin lymphoma. J Natl Cancer Inst. 2005;97:1428–1437
  46. Sklar C, Whitton J, Mertens A. Abnormalities of the thyroid in survivors of Hodgkin's disease: Data from the Childhood Cancer Survivor Study. J Clin Endocrinol Metab. 2000;85:3227–3232
  47. van Leeuwen FE, Klokman WJ, Veer MB. Long-term risk of second malignancy in survivors of Hodgkin's disease treated during adolescence or young adulthood. J Clin Oncol. 2000;18:487–497
  48. Sigurdson AJ, Ronckers CM, Mertens AC. Primary thyroid cancer after a first tumour in childhood (the Childhood Cancer Survivor Study): A nested case-control study. Lancet. 2005;365:2014–2023
  49. Acharya S, Sarafoglou K, LaQuaglia M. Thyroid neoplasms after therapeutic radiation for malignancies during childhood or adolescence. Cancer. 2003;97:2397–2403
  50. Black P, Straaten A, Gutjahr P. Secondary thyroid carcinoma after treatment for childhood cancer. Med Pediatr Oncol. 1998;31:91–95
  51. Tucker MA, Jones PH, Boice JD. Therapeutic radiation at a young age is linked to secondary thyroid cancer (The Late Effects Study Group). Cancer Res. 1991;51:2885–2888
  52. Schneider AB, Ron E, Lubin J. Dose-response relationships for radiation-induced thyroid cancer and thyroid nodules: Evidence for the prolonged effects of radiation on the thyroid. J Clin Endocrinol Metab. 1993;77:362–369
  53. Ronckers CM, Sigurdson AJ, Stovall M. Thyroid cancer in childhood cancer survivors: A detailed evaluation of radiation dose response and its modifiers. Radiat Res. 2006;166:618–628
  54. Bassal M, Mertens AC, Taylor L. Risk of selected subsequent carcinomas in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. J Clin Oncol. 2006;24:476–483
  55. Ferme C, Eghbali H, Meerwaldt JH. Chemotherapy plus involved-field radiation in early-stage Hodgkin's disease. N Engl J Med. 2007;357:1916–1927
  56. Ng AK, Bernardo MP, Weller E. Long-term survival and competing causes of death in patients with early-stage Hodgkin's disease treated at age 50 or younger. J Clin Oncol. 2002;20:2101–2108
  57. Aleman BM, van den Belt-Dusebout AW, Klokman WJ. Long-term cause-specific mortality of patients treated for Hodgkin's disease. J Clin Oncol. 2003;21:3431–3439
  58. Tarbell NJ, Gelber RD, Weinstein HJ. Sex differences in risk of second malignant tumours after Hodgkin's disease in childhood. Lancet. 1993;341:1428–1432
  59. Dores GM, Metayer C, Curtis RE. Second malignant neoplasms among long-term survivors of Hodgkin's disease: A population-based evaluation over 25 years. J Clin Oncol. 2002;20:3484–3494
  60. Hodgson DC, Gilbert ES, Dores GM. Long-term solid cancer risk among 5-year survivors of Hodgkin's lymphoma. J Clin Oncol. 2007;25:1489–1497
  61. Travis LB, Gospodarowicz M, Curtis RE. Lung cancer following chemotherapy and radiotherapy for Hodgkin's disease. J Natl Cancer Inst. 2002;94:182–192
  62. Gilbert ES, Stovall M, Gospodarowicz M. Lung cancer after treatment for Hodgkin's disease: Focus on radiation effects. Radiat Res. 2003;159:161–173
  63. Swerdlow AJ, Schoemaker MJ, Allerton R. Lung cancer after Hodgkin's disease: A nested case-control study of the relation to treatment. J Clin Oncol. 2001;19:1610–1618
  64. Travis LB, Fossa SD, Schonfeld SJ. Second cancers among 40,576 testicular cancer patients: Focus on long-term survivors. J Natl Cancer Inst. 2005;97:1354–1365
  65. Fossa SD, Chen J, Schonfeld SJ. Risk of contralateral testicular cancer: A population-based study of 29,515 U.S. men. J Natl Cancer Inst. 2005;97:1056–1066
  66. Travis LB, Andersson M, Gospodarowicz M. Treatment-associated leukemia following testicular cancer. J Natl Cancer Inst. 2000;92:1165–1171
  67. Pedersen-Bjergaard J, Daugaard G, Hansen SW. Increased risk of myelodysplasia and leukaemia after etoposide, cisplatin, and bleomycin for germ-cell tumours. Lancet. 1991;338:359–363
  68. Kollmannsberger C, Hartmann JT, Kanz L. Therapy-related malignancies following treatment of germ cell cancer. Int J Cancer. 1999;83:860–863
  69. Vaughn DJ, Gignac GA, Meadows AT. Long-term medical care of testicular cancer survivors. Ann Intern Med. 2002;136:463–470
  70. Hayat MJ, Howlader N, Reichman ME. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist. 2007;12:20–37
  71. Kirova YM, Gambotti L, De Rycke Y. Risk of second malignancies after adjuvant radiotherapy for breast cancer: A large-scale, single-institution review. Int J Radiat Oncol Biol Phys. 2007;68:359–363
  72. Gao X, Fisher SG, Emami B. Risk of second primary cancer in the contralateral breast in women treated for early-stage breast cancer: A population-based study. Int J Radiat Oncol Biol Phys. 2003;56:1038–1045
  73. Boice JD, Harvey EB, Blettner M. Cancer in the contralateral breast after radiotherapy for breast cancer. N Engl J Med. 1992;326:781–785
  74. Hill-Kayser CE, Harris EE, Hwang WT. Twenty-year incidence and patterns of contralateral breast cancer after breast conservation treatment with radiation. Int J Radiat Oncol Biol Phys. 2006;66:1313–1319
  75. Storm HH, Jensen OM. Risk of contralateral breast cancer in Denmark 1943-80. Br J Cancer. 1986;54:483–492
  76. Hooning MJ, Aleman BM, Hauptmann M. Roles of radiotherapy and chemotherapy in the development of contralateral breast cancer. J Clin Oncol. 2008;26:5561–5568
  77. Clarke M, Collins R, Darby S. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: An overview of the randomised trials. Lancet. 2005;366:2087–2106
  78. Stovall M, Smith SA, Langholz BM. Dose to the contralateral breast from radiotherapy and risk of second primary breast cancer in the WECARE study. Int J Radiat Oncol Biol Phys. 2008;72:1021–1030
  79. Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials. Lancet. 2005;365:1687–1717
  80. Fisher B, Costantino JP, Redmond CK. Endometrial cancer in tamoxifen-treated breast cancer patients: Findings from the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-14. J Natl Cancer Inst. 1994;86:527–537
  81. Fisher B, Costantino JP, Wickerham DL. Tamoxifen for prevention of breast cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. J Natl Cancer Inst. 1998;90:1371–1388
  82. Magriples U, Naftolin F, Schwartz PE. High-grade endometrial carcinoma in tamoxifen-treated breast cancer patients. J Clin Oncol. 1993;11:485–490
  83. Bergman L, Beelen ML, Gallee MP. Risk and prognosis of endometrial cancer after tamoxifen for breast cancer (Comprehensive Cancer Centres' ALERT Group. Assessment of Liver and Endometrial cancer Risk following Tamoxifen). Lancet. 2000;356:881–887
  84. Saadat M, Truong PT, Kader HA. Outcomes in patients with primary breast cancer and a subsequent diagnosis of endometrial cancer: Comparison of cohorts treated with and without tamoxifen. Cancer. 2007;110:31–37
  85. Brown LM, Chen BE, Pfeiffer RM. Risk of second non-hematological malignancies among 376,825 breast cancer survivors. Breast Cancer Res Treat. 2007;106:439–451
  86. Roychoudhuri R, Evans H, Robinson D. Radiation-induced malignancies following radiotherapy for breast cancer. Br J Cancer. 2004;91:868–872
  87. Neugut AI, Robinson E, Lee WC. Lung cancer after radiation therapy for breast cancer. Cancer. 1993;71:3054–3057
  88. Zablotska LB, Neugut AI. Lung carcinoma after radiation therapy in women treated with lumpectomy or mastectomy for primary breast carcinoma. Cancer. 2003;97:1404–1411
  89. Deutsch M, Land SR, Begovic M. The incidence of lung carcinoma after surgery for breast carcinoma with and without postoperative radiotherapy (Results of National Surgical Adjuvant Breast and Bowel Project (NSABP) clinical trials B-04 and B-06). Cancer. 2003;98:1362–1368
  90. Kirova YM, De Rycke Y, Gambotti L. Second malignancies after breast cancer: The impact of different treatment modalities. Br J Cancer. 2008;98:870–874
  91. Travis LB, Curtis RE, Inskip PD. Re: Lung cancer risk and radiation dose among women treated for breast cancer. J Natl Cancer Inst. 1995;87:60–61
  92. Neugut AI, Murray T, Santos J. Increased risk of lung cancer after breast cancer radiation therapy in cigarette smokers. Cancer. 1994;73:1615–1620
  93. Ford MB, Sigurdson AJ, Petrulis ES. Effects of smoking and radiotherapy on lung carcinoma in breast carcinoma survivors. Cancer. 2003;98:1457–1464
  94. Kaufman EL, Jacobson JS, Hershman DL. Effect of breast cancer radiotherapy and cigarette smoking on risk of second primary lung cancer. J Clin Oncol. 2008;26:392–398
  95. Zablotska LB, Chak A, Das A. Increased risk of squamous cell esophageal cancer after adjuvant radiation therapy for primary breast cancer. Am J Epidemiol. 2005;161:330–337
  96. Huang J, Mackillop WJ. Increased risk of soft tissue sarcoma after radiotherapy in women with breast carcinoma. Cancer. 2001;92:172–180
  97. Karlsson P, Holmberg E, Samuelsson A. Soft tissue sarcoma after treatment for breast cancer—a Swedish population-based study. Eur J Cancer. 1998;34:2068–2075
  98. Kirova YM, Vilcoq JR, Asselain B. Radiation-induced sarcomas after radiotherapy for breast carcinoma: A large-scale single-institution review. Cancer. 2005;104:856–863
  99. Rubino C, de Vathaire F, Shamsaldin A. Radiation dose, chemotherapy, hormonal treatment and risk of second cancer after breast cancer treatment. Br J Cancer. 2003;89:840–846
  100. Jessner M, Zak FG, Rein CR. Angiosarcoma in postmastectomy lymphedema (Stewart-Treves syndrome). AMA Arch Derm Syphilol. 1952;65:123–129
  101. Esler-Brauer L, Jaggernauth W, Zeitouni NC. Angiosarcoma developing after conservative treatment for breast carcinoma: Case report with review of the current literature. Dermatol Surg. 2007;33:749–755
  102. Virtanen A, Pukkala E, Auvinen A. Angiosarcoma after radiotherapy: A cohort study of 332,163 Finnish cancer patients. Br J Cancer. 2007;97:115–117
  103. Simonart T, Heenen M. Radiation-induced angiosarcomas. Dermatology. 2004;209:175–176
  104. Curtis RE, Boice JD, Stovall M. Risk of leukemia after chemotherapy and radiation treatment for breast cancer. N Engl J Med. 1992;326:1745–1751
  105. Praga C, Bergh J, Bliss J. Risk of acute myeloid leukemia and myelodysplastic syndrome in trials of adjuvant epirubicin for early breast cancer: Correlation with doses of epirubicin and cyclophosphamide. J Clin Oncol. 2005;23:4179–4191
  106. Campone M, Roche H, Kerbrat P. Secondary leukemia after epirubicin-based adjuvant chemotherapy in operable breast cancer patients: 16 years experience of the French Adjuvant Study Group. Ann Oncol. 2005;16:1343–1351
  107. Smith RE, Bryant J, DeCillis A. Acute myeloid leukemia and myelodysplastic syndrome after doxorubicin-cyclophosphamide adjuvant therapy for operable breast cancer: The National Surgical Adjuvant Breast and Bowel Project Experience. J Clin Oncol. 2003;21:1195–1204
  108. Chen PY, Vicini FA. Partial breast irradiation: patient selection, guidelines for treatment, and current results. Front Radiat Ther Oncol. 2007;40:253–271
  109. Moon K, Stukenborg GJ, Keim J. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006;107:991–998
  110. Kendal WS, Eapen L, Macrae R. Prostatic irradiation is not associated with any measurable increase in the risk of subsequent rectal cancer. Int J Radiat Oncol Biol Phys. 2006;65:661–668
  111. Chrouser K, Leibovich B, Bergstralh E. Bladder cancer risk following primary and adjuvant external beam radiation for prostate cancer. J Urol. 2005;174:107–110discussion 110-101
  112. Pickles T, Phillips N. The risk of second malignancy in men with prostate cancer treated with or without radiation in British Columbia, 1984-2000. Radiother Oncol. 2002;65:145–151
  113. Brenner DJ, Curtis RE, Hall EJ. Second malignancies in prostate carcinoma patients after radiotherapy compared with surgery. Cancer. 2000;88:398–406
  114. Guckenberger M, Flentje M. Intensity-modulated radiotherapy (IMRT) of localized prostate cancer: A review and future perspectives. Strahlenther Onkol. 2007;183:57–62
  115. Kry SF, Salehpour M, Followill DS. The calculated risk of fatal secondary malignancies from intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys. 2005;62:1195–1203
  116. Pulte D, Gondos A, Brenner H. Improvement in survival in younger patients with acute lymphoblastic leukemia from the 1980s to the early 21st century. Blood. 2009;113:1408–1411
  117. Preston DL, Mattsson A, Holmberg E. Radiation effects on breast cancer risk: A pooled analysis of eight cohorts. Radiat Res. 2002;158:220–235
  118. Inskip P, Robison L, Stovall M. Radiation dose and breast cancer risk in the childhood cancer survivor study. J Clin Oncol. 2009;27:3901–3907
  119. Emmons KM, Puleo E, Mertens A. Long-term smoking cessation outcomes among childhood cancer survivors in the Partnership for Health Study. J Clin Oncol. 2009;27:52–60

PII: S1053-4296(09)00067-8

doi: 10.1016/j.semradonc.2009.09.002

Seminars in Radiation Oncology
Volume 20, Issue 1 , Pages 67-78 , January 2010