{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:16:25Z","timestamp":1782602185944,"version":"3.54.5"},"reference-count":37,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,3,22]],"date-time":"2016-03-22T00:00:00Z","timestamp":1458604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"name":"Research Committe, University of Crete","award":["4254"],"award-info":[{"award-number":["4254"]}]},{"name":"Research Committe, University of Crete","award":["4254"],"award-info":[{"award-number":["4254"]}]}],"content-domain":{"domain":["aip.org"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec><jats:title>Purpose:<\/jats:title><jats:p>Vertebral hemangiomas (VHs) are the most common benign tumors of the spine that may cause bone resorption. Megavoltage irradiation is usually the treatment of choice for the management of symptomatic VHs. The current study was conducted to estimate the risk for carcinogenesis from radiotherapy of this benign disease on the basis of the calculated radiation doses to healthy organs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>The Monte Carlo N\u2010particle transport code was employed to simulate the irradiation with 6 MV x\u2010rays of a VH presented in the cervical, upper thoracic, lower thoracic, and lumbar spine. The average radiation dose (<jats:italic>D<\/jats:italic><jats:sub>av<\/jats:sub>) received by each critical organ located outside the primarily irradiated area was calculated. Three\u2010dimensional treatment plans were also generated for the VHs occurring at the four different sites of the spinal cord based on patients\u2019 computed tomography data. The organ equivalent dose (OED) to each radiosensitive structure, which was partly encompassed by the applied treatment fields, was calculated with the aid of differential dose\u2013volume histograms. The <jats:italic>D<\/jats:italic><jats:sub>av<\/jats:sub> and the OED values were combined with a linear\u2010no\u2010threshold model and a nonlinear mechanistic model, respectively, to estimate the organ\u2010, age\u2010, and gender\u2010specific lifetime attributable risks (LARs) for cancer development. The estimated risks were compared with the respective nominal lifetime intrinsic risks (LIRs) for the unexposed population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>For a standard target dose of 34 Gy, the OED varied from 0.39\u20135.15 Gy by the organ of interest and the irradiation site. The <jats:italic>D<\/jats:italic><jats:sub>av<\/jats:sub> range for the out\u2010of\u2010field organs was 4.9 \u00d7 10<jats:sup>\u22124<\/jats:sup> to 0.56 Gy. The LAR for the appearance of malignancies in the partially in\u2010field organs after radiotherapy of male and female patients was (0.08%\u20131.8%) and (0.09%\u20131.9%), respectively. These risk values were 1.5\u201315.5 times lower when compared to the respective LIRs. The lifetime probability for out\u2010of\u2010field cancer induction in irradiated males and females was (2.5 \u00d7 10<jats:sup>\u22124<\/jats:sup> to 7.7 \u00d7 10<jats:sup>\u22122<\/jats:sup>)% and (1.4 \u00d7 10<jats:sup>\u22124<\/jats:sup> to 2.6 \u00d7 10<jats:sup>\u22121<\/jats:sup>)%, respectively. The above risks were one to four orders of magnitude lower than the LIRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>The probability for the development of out\u2010of\u2010field malignancies due to radiotherapy for VHs is trivial with respect to the nominal risk for unexposed population. The respective cancer risks to partially in\u2010field organs are smaller than the nominal probabilities but they should not be considered as inconsiderable. These risks may be taken into account during the follow\u2010up of patients treated for a symptomatic VH.<\/jats:p><\/jats:sec>","DOI":"10.1118\/1.4944422","type":"journal-article","created":{"date-parts":[[2016,3,23]],"date-time":"2016-03-23T00:31:07Z","timestamp":1458693067000},"page":"1841-1848","update-policy":"https:\/\/doi.org\/10.1063\/aip-crossmark-policy-page","source":"Crossref","is-referenced-by-count":22,"title":["Radiation dose and cancer risk to out\u2010of\u2010field and partially in\u2010field organs from radiotherapy for symptomatic vertebral hemangiomas"],"prefix":"10.1002","volume":"43","author":[{"given":"Michalis","family":"Mazonakis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis","family":"Tzedakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrossyni","family":"Lyraraki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Damilakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,22]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-540-68943-0_23"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123\u2010199611000\u201000039"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/02841869709001344"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2011.04.028"},{"key":"e_1_2_7_6_1","first-page":"1091","article-title":"Alcohol ablation of symptomatic vertebral hemangiomas","volume":"20","author":"Goyal M.","year":"1999","journal-title":"Am. 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