@article{oai:repo.qst.go.jp:00047436,
 author = {Imaoka, Tatsuhiko and Ishii, Nobuyoshi and Kawaguchi, Isao and Homma-Takeda, Shino and Doi, Kazutaka and Daino, Kazuhiro and Nakanishi, Ikuo and Tagami, Keiko and Kokubo, Toshiaki and Morioka, Takamitsu and Hosoki, Ayaka and Takabatake, Masaru and Yoshinaga, Shinji and 今岡 達彦 and 石井 伸昌 and 川口 勇生 and 武田 志乃 and 土居 主尚 and 臺野 和広 and 中西 郁夫 and 田上 恵子 and 小久保 年章 and 森岡 孝満 and 細木 彩夏 and 高畠 賢 and 吉永 信治},
 issue = {6},
 journal = {International Journal of Radiation Biology},
 month = {Mar},
 note = {Purpose: Second cancers are among the most serious sequelae for cancer survivors who receive radiotherapy. This article aims to review current knowledge regarding how the risk of radiotherapy-associated second cancer can be minimized by biological measures and to discuss relevant research needs. 
Results: The risk of second cancer can be reduced not only by physical measures to decrease the radiation dose to normal tissues but also by biological means that interfere with the critical determinants of radiation-induced carcinogenesis. Requirements for such biological means include the targeting of tumor types relevant to radiotherapy-associated risk, concrete safety and efficacy evidence and feasibility and minimal invasiveness. Mechanistic insights into the process of radiation carcinogenesis provide rational approaches to minimize the risk. Five mechanism-based strategies are proposed herein based on the current state of knowledge. Epidemiological studies on the joint effects of radiation and lifestyle or other factors can provide evidence for factors that modify radiation-associated risks if deliberately controlled.
Conclusions: Mechanistic and epidemiological evidence indicates that it is possible to develop interventional measures to minimize the second cancer risk associated with radiotherapy. Research is needed regarding the critical determinants of radiation-induced carcinogenesis available for intervention and joint effects of radiation and controllable factors.},
 pages = {289--301},
 title = {Biological measures to minimize the risk of radiotherapy-associated second cancer: a research perspective},
 volume = {92},
 year = {2016}
}