{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:24:35Z","timestamp":1793157875970,"version":"4.5.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T00:00:00Z","timestamp":1656547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004622","name":"Dutch Cancer Society","doi-asserted-by":"crossref","award":["KWF10004"],"award-info":[{"award-number":["KWF10004"]}],"id":[{"id":"10.13039\/501100004622","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Breast cancer (BC) risk is increased among Hodgkin lymphoma (HL) survivors treated with chest radiotherapy. Case-control studies showed a linear radiation dose-response relationship for estimated dose to the breast tumor location. However, these relative risks cannot be used for absolute risk prediction of BC anywhere in the breasts. Furthermore, the independent and joint effects of radiation dose and irradiated volumes are unclear. Therefore, we examined the effects of mean breast dose and various dose-volume parameters on BC risk in HL patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a nested case-control study of BC among 5-year HL survivors (173 case patients, 464 matched control patients). Dose-volume histograms were obtained from reconstructed voxel-based 3-dimensional dose distributions. Summary parameters of dose-volume histograms were studied next to mean and median breast dose, Gini index, and the new dose metric mean absolute difference of dose, using categorical and linear excess odds ratio (EOR) models. Interactions between dose-volume parameters and mean dose were also examined.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Statistically significant linear dose-response relationships were observed for mean breast dose (EOR per Gy = 0.19, 95% confidence interval [CI] = 0.05 to 1.06) and median dose (EOR\/Gy = 0.06, 95% CI = 0.02 to 0.19), with no statistically significant curvature. All metrics except Gini and mean absolute difference were positively correlated with each other. These metrics all showed similar patterns of dose-response that were no longer statistically significant when adjusting for mean dose. No statistically significant modification of the effect of mean dose was observed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Mean breast dose predicts subsequent BC risk in long-term HL survivors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jnci\/djac125","type":"journal-article","created":{"date-parts":[[2022,6,30]],"date-time":"2022-06-30T15:56:19Z","timestamp":1656604579000},"page":"1270-1278","source":"Crossref","is-referenced-by-count":26,"title":["Radiotherapy-Related Dose and Irradiated Volume Effects on Breast Cancer Risk Among Hodgkin Lymphoma Survivors"],"prefix":"10.1093","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-7442","authenticated-orcid":false,"given":"Sander","family":"Roberti","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Flora E","family":"van Leeuwen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3524-4657","authenticated-orcid":false,"given":"C\u00e9cile M","family":"Ronckers","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Registry Research, Brandenburg Medical School Theodor Fontane , Neuruppin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge M","family":"Krul","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute , Amsterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8374-9281","authenticated-orcid":false,"given":"Florent","family":"de Vathaire","sequence":"additional","affiliation":[{"name":"Radiation Epidemiology Team, Center for Research in Epidemiology and Population Health, INSERM U1018 , Villejuif, France"},{"name":"Research Department, Gustave Roussy , Villejuif, France"},{"name":"University Paris Saclay , Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Veres","sequence":"additional","affiliation":[{"name":"University Paris Saclay , Villejuif, France"},{"name":"Molecular Radiation Therapy and Therapeutic Innovation, INSERM U1030 , Villejuif, France"},{"name":"Radiation Oncology Department, Gustave Roussy , Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8272-8817","authenticated-orcid":false,"given":"Ibrahima","family":"Diallo","sequence":"additional","affiliation":[{"name":"University Paris Saclay , Villejuif, France"},{"name":"Molecular Radiation Therapy and Therapeutic Innovation, INSERM U1030 , Villejuif, France"},{"name":"Radiation Oncology Department, Gustave Roussy , Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3860-8698","authenticated-orcid":false,"given":"C\u00e9cile P M","family":"Janus","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Erasmus MC Cancer Institute , Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthe M P","family":"Aleman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The Netherlands Cancer Institute , Amsterdam, the 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