High-Dose Abdominal Radiotherapy and Risk of Diabetes Mellitus | Gastroenterology | JAMA Internal Medicine | JAMA Network
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Research Letter
September 13, 2010

High-Dose Abdominal Radiotherapy and Risk of Diabetes Mellitus

Author Affiliations

Author Affiliations: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services (Ms Kleinerman and Dr Mabuchi), and RTI International (Mr Weinstock), Rockville, Maryland.

Arch Intern Med. 2010;170(16):1506-1507. doi:10.1001/archinternmed.2010.285

Meacham et al1 reported a significantly increased risk of diabetes mellitus (DM) following abdominal irradiation for childhood cancer, separate from the effect of total irradiation. Prompted by this finding of an increased risk of DM, we examined the risk of death from diabetes in a cohort of patients with peptic ulcers, who were treated with high-dose abdominal radiation to decrease acid secretion.

This cohort study, originally initiated to investigate the long-term cancer risk associated with radiation,2,3 consisted of 1832 irradiated and 1868 nonirradiated patients with peptic ulcers (treated by other means) at the University of Chicago from 1937 to 1965. Individual radiation doses were estimated to specific organs from radiotherapy records and phantom experimental measurements. Doses to the pancreas ranged from 1 to 38 Gy (to convert to rads, multiply by 100), which is the equivalent of 1000 to 38 000 mSv (1 chest radiograph = 0.1 mSv). The mean age at treatment was 49 years for irradiated and 45 years for nonirradiated patients. Individuals were followed up from the time of treatment for peptic ulcer until death or censored alive as of December 31, 1997. Causes of death were obtained by linking the cohort with the National Death Index. At the end of follow-up, 84% of irradiated and 81% of nonirradiated patients had died.