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PubMedDate not supplied

Radium in Wisconsin drinking water: an analysis of osteosarcoma risk.

Epidemiological studies of radium dial painters have found an association between exposure to high-dose radium and bone cancers. However, only limited data exist on the relationship between low doses of radium, as are found in some drinking water sources, and osteosarcoma. The authors conducted a population-based case-control study to examine the association between exposure to radium in drinking water and the occurrence of osteosarcoma. Estimates of radium exposure and covariates used were based on subjects' residential ZIP codes. The median radium level was not significantly associated with osteosarcoma (odds ratio = .98; 95% confidence interval = .93, 1.04; p = .56). The authors found no evidence that radium, at current levels in Wisconsin drinking water, resulted in excess cases of osteosarcoma.

Adolescent↗
PubMed2000

American radium engenders telecurie therapy during World War I.

From 1899 to 1912 there was a European monopoly controlling the sale of radium for cancer therapy. This trust was finally broken, albeit only temporarily, in 1912/13 by American entrepreneurs J. Flannery, H. Kelly, and J. Douglas. Joe Flannery was a former mortician turned mining magnate. Dr. Howard Kelly was the renowned gynecological surgeon at Johns Hopkins Hospital and Medical School who defied tradition by maintaining his own private hospital. Professor James Douglas was the Arizona copper king who helped support Memorial Hospital in New York City as America's first cancer hospital. During 1913-1916 surgeons Howard Kelly (Baltimore) and H. H. Janeway (Memorial Hospital) began using radium and radon for the treatment of deep seated cancers. Their technique required placement of the sources several centimeters away from the skin surface. As this new concept, telecurie therapy, resulted in a significant decrease in dose rate, it was necessary for both surgeons to have several grams of radium, costing $180000/gram, in their possession. Fortunately, Kelly and Janeway were the sole beneficiaries of a radium mining company, the National Radium Institute, from 1913 to 1916. With this unique American source of radium and with Europe otherwise preoccupied, these two American surgeons pioneered megavoltage telecurie therapy, using the 1.2 MeV gamma rays of "mass radium."

Biophysics↗
PubMed1990

Radithor and the era of mild radium therapy.

Soon after the discovery of radium, a school of practitioners arose who were interested primarily in the physiological rather than the tumoricidal powers of this new radioactive element. This treatment philosophy was called "mild radium therapy" and involved the oral or parenteral administration of microgram quantities of radium and its daughter isotopes, often as cures for rheumatic diseases, hypertension, and metabolic disorders. Manufacturers of patent medicines responded to this market by producing a variety of over-the-counter radioactive preparations including pills, elixirs, and salves. One such nostrum was Radithor, a popular and expensive mixture of radium 226 and radium 228 in distilled water. Radithor was advertised as an effective treatment for over 150 "endocrinologic" diseases, especially lassitude and sexual impotence. Over 400,000 bottles, each containing over 2 muCi (74 kBq) of radium, were apparently marketed and sold worldwide between 1925 and 1930. The death of the Pittsburgh millionaire sportsman Eben M. Byers, who was an avid Radithor user, by radium poisoning in 1932 brought an end to this era and prompted the development of regulatory controls for all radiopharmaceuticals.

Alpha Particles↗
PubMed1990

The metabolism of radium-226 during pregnancy in the rat.

Metabolism of radium including the transfer to the fetus through the placenta was studied during three successive pregnancies 92, 155, and 213 days after injection of 226Ra in young female rats. The cumulative fecal and urinary excretions of 226Ra in a 213-day period following injection were about 30 and 15% injected dose (%ID), respectively, most of them occurring during the first 42 days. The excretions were similar in both the pregnant and control (unmated) rats. The whole-body burden of radium (mostly in the skeleton) determined by actual analysis of the entire body was similar in the two groups and was about 53, 48, and 44 %ID at the first, second, and third pregnancy, respectively. Pregnancy alone, therefore, did not significantly affect metabolism of radium. At 20 days of gestation the mean placental content of radium was 0.005, 0.0045, and 0.0036 %ID in the first, second, and third litter, respectively; the corresponding mean fetal content was 0.01, 0.008, and 0.005 %ID. The radium burden of the full-term neonate (21-22 days) was 0.014 and 0.011 %ID for the first and second delivery, respectively. The total amount calculated of radium transferred from the mother to the 8-10 fetuses in a litter did not exceed about 0.3% of the maternal content per each pregnancy. Comparison of the ratio of radium and calcium in the fetus and maternal skeleton shows that there is a Ra-Ca discrimination during their passage from the mother to the fetus.

Animals↗
PubMed2004

[No convincing evidence for a causal relationship between childhood nasopharyngeal radium irradiation and head-neck tumors or hormone-related disorders later in life; a retrospective cohort study].

OBJECTIVE: To study the risk of malignant and benign tumours and hormone-related disorders among patients treated with nasopharyngeal radium irradiation for hypertrophic adenoid or hearing loss caused by otitis media serosa. DESIGN: Retrospective cohort study. METHOD: The medical record registries of 9 hospitals were used to identify a radium-exposed group (n = 5358) and a control group of unexposed patients (n = 5265), who were treated by an otolaryngologist in the period 1945-1981. The vital status of the subjects was determined using municipal resident registries, and the cause of death of decedents was retrieved from Statistics Netherlands (1950-1997). The data was also coupled with the Netherlands Cancer Registry (1989-1996). For the subjects still alive in 1997, the prevalence of relevant disorders was determined using a self-administered questionnaire and disorders reported by the participants were medically verified. The risk of disease in the radium group was then compared with that of the control group. RESULTS: The average radiation doses were 2.75, 0.109 and 0.015 Gy for nasopharynx, pituitary, and thyroid, respectively. There was no statistically significantly elevated risk for malignancies of the head and neck area (radium-exposed group; n = 14; control group: n = 11 (relative risk (RR): 1.2; 95% CI: 0.6-2.8)). Four of the five thyroid carcinomas were found in the radium-exposed group (RR: 3.8; 0.5-76). Elevated risks were observed for breast cancer (RR: 1.6; 0.9-2.7) and non-Hodgkin's lymphoma (RR: 2.7; 1.0-8.7). There was an increased risk for skin basal cell carcinoma (BCC) of the head and neck (odds ratio (OR): 2.6; 1.0-6.7), but the risk of BCC of other body parts was lower (OR: 0.3; 0.1-1.3). There were no major differences between radium and control subjects with respect to benign head and neck tumours (OR: 1.0; 0.5-1.7) or hormonal disorders. Exposed men reported slightly more fertility disorders than men in the control group (OR: 1.4; 1.0-2.1), but there was no clear dose-response relationship. CONCLUSION: After a mean follow-up of 31 years, there was no strong evidence for an elevated risk of head and neck tumours or hormone-related disorders in adulthood among subjects who had been treated with nasopharyngeal radium irradiation during childhood.

Adolescent↗
PubMed1983

Plugged haversian canals and local dose in radium cases.

Haversian canal plugging is a common lesion in bone from human radium cases, signaling vascular damage. Its incidence is correlated with the whole body radium dose. However, since the vascular supply to bone forms an extensive anastomotic plexus facilitating propagation of vascular damage from a primary site of high radium content, we do not know if the degree of plugging is related to the local bone dose. In this report, we compare the incidence of plugging of osteons in different regions (16 sections) of humeri of three radium cases with terminal 226Ra body contents of 0.203, 1.03 and 15.4 muCi to the local dose of radium in adjacent bone sections. While the first and third subjects had received 226Ra only, the second had had a large intake of 228Ra as well. The background incidence of plugging in 35 "normal" humeri from dissecting room populations (45-90 yr) ranged from 0 to 1%, with an average of 0.3%. The least squares linear regression equation for the relation between the percent of canals plugged (PCP) and dose, PCP = (0.00214 +/- 0.00014) rad + (3.26 +/- 3.6), predicts for our three radium cases a development of about 0.002% plugs/rad. The correlation coefficient was very high (r = 0.97, n = 16, P less than 0.01). When normalized to radiation dose from the two decay series, 226Ra and 228Ra appear to be equally effective in producing plugged canals.

Adult↗
PubMed1979

[The influence of radium therapie on the yeast contamination of the vagina (author's transl)].

Before the beginning of radium therapy a vaginal yeast contamination of 9,7% was found of 113 patients with different genital carcinomas. However, the incidence of vaginal yeast contamination increased suddenly to 30,9% under the contac irradiation therapy with radium. The radiation effect of radium is not sufficient for a "selfsterilisation" of the radium-carrier in the case of yeast contamination. Therefore, a chemic desinfection of the radium-carriers is principly necessary. The significance of radium therapy with respect to vaginal yeast contamination is discussed and the recommendation is made that routine mycological supervision be carried out on all patients with gynaecological carcinomas and appropriate antimycotic therapy initiated where necessary.

Adult↗
PubMed1976

Radical hysterectomy with or without preoperative radium for stage IB squamous cell carcinoma of the cervix.

A retrospective study of 119 patients ranging from 30 to 69 years of age was undertaken to evaluate the effectiveness of preoperative radium treatment for patients with Stage IB (FIGO 1971) squamous cell carcinoma of the cervix undergoing radical hysterectomy. Results in 61 patients who had radical hysterectomy without preoperative radium treatment were compared to those in 58 patients who had received radium preoperatively. The patients receiving radium systems had an uncorrected 5-year survival rate of 89.7%, while the patients without preoperative radium treatment had a 75.1% 5-year rate of survival. This difference in survival rate was judged to be secondary to the greater incidence of lymphatic invasion and residual tumor in the surgical specimens of the patients who did not receive preoperative radium. The occurrence of significant gastrointestinal and urinary tract complications was identical in the 2 groups.

Adult↗
PubMed1997

Evaluation of internal alpha-particle radiation exposure and subsequent fertility among a cohort of women formerly employed in the radium dial industry.

This study examined the effect of internal exposure to alpha-particle radiation on subsequent fertility among women employed in the radium dial industry prior to 1930, when appreciable amounts of radium were often ingested through the practice of pointing the paint brush with the lips. The analysis was limited to women for whom a radium body burden measurement had been obtained and who were married prior to age 45 (n = 603). Internal radiation dose to the ovary was calculated based on initial intakes of radium-226 and radium-228, average ovarian mass, number and energy of alpha particles emitted, fraction of energy absorbed within the ovary, effective retention integrals and estimated photon irradiation. Time between marriage and pregnancy, number of pregnancies and number of live births served as surrogates for fertility. Radiation appeared to have no effect on fertility at estimated cumulative ovarian dose equivalents below 5 Sv; above this dose, however, statistically significant declines in both number of pregnancies and live births were observed. These trends persisted after multivariable adjustment for potential confounding variables and after exclusion of subjects contributing a potential classification or selection bias to the study. Additionally, the high-dose group experienced fewer live births than would have been expected based on population rates. There were no differences in time to first pregnancy between high- and low-dose groups. These results are consistent with earlier studies of gamma-ray exposures and suggest that exposure to high doses of radiation from internally deposited radium reduces fertility rather than inducing sterility.

Abortion, Spontaneous↗
PubMed1963

Radium-226 in human diet and bone.

The mean radium-226 content of samples of vertebrae from New York City and San Francisco is 0.032 and 0.026 picocuries of radium-226 per gram of calcium, respectively. The ratio of these two mean values is associated with a similar ratio of radium-226 to calcium found in the diet at the two locations. A plot of the radium-226 content of bone as a function of age indicates that there is no marked difference in levels of bone radium with age.

Bone and Bones↗
PubMed1998

The centenary of discovery of radium.

Henri Becquerel presented the discovery of radium by Pierre and Marie Curie at the Paris Academy of Science on 26th December 1898. One century later, radium has been abandoned, mainly for radiation protection difficulties. It is, however, likely that modern techniques of brachytherapy have inherited to those designed for radium sources, and that radium has cured thousands and thousands patients all over the world for about eighty years. The history of discovery and medical use of radium is summarised.

Famous Persons↗
PubMedDate not supplied

[The centenary of the discovery of radium].

Henri Becquerel presented the discovery of radium by Pierre and Marie Curie at the Paris Académie des Sciences on 26th December 1898. One century later, radium has been abandoned, mainly for the reason of radiation safety concerns. It is, however, likely that modern techniques of brachytherapy are the successors of those designed for radium sources, and that radium has cured thousands and thousands patients all over the word for about 80 years. The history of discovery and medical use of radium is summarised.

France↗
PubMed1999

Procedure for analysis of radium in freshwaters by adsorption on basic lead rhodizonate.

Radium analysis is carried out by batch adsorption from natural waters on basic lead rhodizonate supported on charcoal, LERHO, starting from 2-L samples. 133Ba is added to allow the measurement of the overall chemical yield by gamma counting. Radium is recovered with a few milliliters of 1.5 M HCl, and lead is removed by a chromatographic column filled with Dowex 2 x 8. Finally 50 micrograms of barium carrier is added, and the radium is coprecipitated as sulfate on a preformed bed of barium sulfate, to prepare a sample suitable for alpha and gamma counting. The detection limit of the proposed method is 0.002 Bq/L 226Ra. This value is far beyond the radium activity admissible for drinking waters. Due to lack of appropriate samples, the procedure was tested using mineral waters spiked with 226Ra and two commercially available mineral waters with very low radium contents.

Adsorption↗
PubMed1980

The decontamination of radium from a commercial building located in a large Canadian city.

In August, 1975, the Ministry of Health of the Province of Ontario at the request of one of the tenants of a building in a large Canadian city conducted a radiation survey of the third floor of the building. The survey, although preliminary, showed that high radiation existed on the third and second floors and that significant contamination existed in some other parts of the six-floor building. The contamination was identified as radium-226. An investigation revealed that the third floor of the building had been used during World War II for processing radium and also for some radium dial painting work. The Atomic Energy Control tboard (AECB) requested Atomic Energy of Canadian Limited (AECL) to remove the radium contaminant from the building. AECL assigned the job to its Chalk River Nuclear Laboratories (CRNL). The objectives were to reduce the radium concentration throughout the building so that radon decay products would be less than 0.02 Working Levels (WL) and exposure rates would be less than 50 microR/h. The techniques used and the extent of decontamination achieved are reported.

Accidents↗
PubMed1996

Radium in drinking water and risk of bone cancer in Ontario youths: a second study and combined analysis.

OBJECTIVES: Radium induces bone sarcomas at high doses, but there is controversy about risk at low doses. A previous study in Ontario found an association between the presence of radium in birthplace water supplies and an increased risk of death from bone cancer in young people. An investigation was performed to test the findings of the previous study with an independent group of subjects for whom complete information on radium exposure would be obtained. METHODS: A population based case-control study (238 cases; 432 controls) was conducted with incident cases of bone sarcoma identified from the Ontario cancer registry. Residential histories were collected by questionnaire and water samples were obtained and analysed for radium content. RESULTS: There was an association between risk of osteosarcoma and birthplace exposures (odds ratios (ORs) and 90% confidence intervals (90% CIs) 1.77 (1.03-3.00) but not with lifetime measures of exposure. When lifetime exposure was dichotomised, the OR was 1.31 (0.76-2.24) for osteosarcoma. There was no trend with increasing exposure. Bootstrap resampling was used to simulate lifetime doses in a pooled analysis of 1293 subjects from the two Ontario studies. The ORs were 1.38 (1.08-1.73) for all sarcomas, and 1.44 (1.01-1.87) for osteosarcoma. Geometric mean doses in bone were about 26 mRad. CONCLUSIONS: An association was found between the presence of radium in birthplace water supplies and increased risk of bone sarcoma in two studies. Increased risk was present for lifetime measures of exposure, but the association was not significant, and there was no dose-response trend. Our findings are compatible with the absence of risk at low doses, but they might also reflect inadequate statistical power to measure a true risk at environmental exposure levels. If the increased risk at environmental doses is causal, risk of bone sarcoma is effectively linearly related to dose over five orders of magnitude.

Adolescent↗
PubMed1996

Military use of nasopharyngeal irradiation with radium during World War II.

Published reports of the military use of nasopharyngeal irradiation during World War II include treatment of U.S. aviators in England, the aerotitis control program of the Army Air Forces, treatment of Navy submarine trainees at New London, Connecticut, and other miscellaneous reports. In England, Army aviators developed hyperplastic lymphoid tissue in the nasopharynx. Radon applicators were used to treat 220 Army aviators from 1942 to 1944. The radium applicator provided a much more stable applicator and allowed much shorter exposure times, making it suitable for field use. From 1944 to 1945 the Army Air Forces had an aerotitis control program that was developed on the recommendations of an expert panel convened by the air surgeon. Nasopharyngeal radium was used to treat 6881 aviators. Hyperplastic lymphoid tissue was also a problem in submarine escape training at New London. Reports indicate that 732 Navy submariners were treated with nasopharyngeal radium. Other documented military use included 60 Navy aviators by Northington and 277 aviators in the Pacific theater. The total number of U.S. military personnel treated in World War II is 8170. After the war, there were no indications that the Army or Air Force continued to use nasopharyngeal radium, but it was used by the Navy at New London for some time. Precise numbers treated are unknown, and it is unclear when use of nasopharyngeal radium irradiation was stopped.

Humans↗
PubMed2026

Phase II Randomized Trial of Radium-223 Dichloride and Cabozantinib in Patients With Renal Cell Carcinoma With Bone Metastases: RADICAL (Alliance A031801).

PURPOSE: Bone metastases (BM) occur in approximately 30% of patients with metastatic renal cell carcinoma (mRCC) and are associated with poor survival and symptomatic skeletal events (SSEs). Radium-223, an alpha-emitting bone-seeking radioisotope, and cabozantinib, a tyrosine kinase inhibitor, have demonstrated activity in BM. RADICAL (Alliance A031801; ClinicalTrials.gov identifier: NCT04071223) evaluated cabozantinib ± radium-223 in mRCC with BM. METHODS: This phase II trial enrolled patients with mRCC of any histology with ≥1 BM. Patients were randomly assigned 1:1 to cabozantinib ± radium-223, stratified by osteoclast-targeted therapy (OTT), prior therapy, opioid use, and International mRCC Database Consortium (IMDC) risk. The primary end point was SSE-free survival (SSE-FS). Secondary end points included safety, objective response rate (ORR), progression-free survival, and overall survival (OS). A target of 124 evaluable patients was planned, with a prespecified interim futility analysis at 50% of expected SSE-FS events; the trial would stop if the stratified hazard ratio (sHR) > 1.0. RESULTS: The prespecified interim futility analysis was conducted after 90 patients were enrolled and crossed the futility boundary, leading to closure at 98 patients. The final analysis included all 98 patients. Median age was 63 years, 82.7% had clear cell histology, and 79.6% were using an OTT. IMDC risk was favorable (18.4%), intermediate (67.3%), and poor (14.3%). Median follow-up was 13.1 months. Median SSE-FS for cabozantinib with radium-223 versus cabozantinib was 16.7 versus 17.6 months (sHR, 1.46 [90% CI, 0.86 to 2.51]). Median OS was 28.3 versus 19.7 months (sHR, 1.40 [95% CI, 0.70 to 2.79]). ORR was 19.4% versus 25.0% (P = .78). Grade ≥3 adverse events were similar across arms (69.6% v 75.5%). CONCLUSION: Radium-223 did not improve SSE-FS when added to cabozantinib. The combination demonstrated a manageable safety profile.

Humans↗
PubMed1978

Radium-induced malignant tumors of the mastoid and paranasal sinuses.

In the records of 5,058 persons with therapeutic or occupational exposure to radium, 21 patients with carcinoma of the mastoid and 11 with malignant tumors of the paranasal sinuses were identified. Tumor induction times were 21-50 years for mastoid tumors (median, 33) and 19-52 years for paranasal sinus tumors (median, 34). Dosimetric data are given for the patients whose body burdens of radium have been measured. We found a high proportion of mucoepidermoid carcinoma, comprising 38% of the mastoid and 36% of the paranasal sinus tumors. Three patients had antecedent bone sarcoma at 20, 11, and 5 years, respectively, and a bone sarcoma was discovered at autopsy in a fourth patient. Radiographic changes in the mastoid and paranasal sinuses were similar to those seen in nonradium malignant tumors. More than 800 known persons exposed to radium before 1930 and another group of unknown size who received radium water or injections of radium from physicians are still alive and at risk of developing malignant tumors of the mastoid and paranasal sinuses.

Adenocarcinoma↗