Laura Mezquita1, Amparo Benito2, Alberto Ruano-Raviña3, Javier Zamora4, Maria Eugenia Olmedo5, Pablo Reguera5, Ainhoa Madariaga5, María Villamayor5, Silvia Patricia Cortez5, Luis Gorospe6, Almudena Santón2, Sagrario Mayoralas7, Raúl Hernanz8, Alberto Cabañero9, Edouard Auclin10, Alfredo Carrato11, Pilar Garrido12. 1. Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medical Oncology Department, Gustave Roussy Cancer Center, Villejuif, France. 2. Pathology Department, Ramón y Cajal University Hospital, Madrid, Spain. 3. Public Health Department, School of Medicine Santiago de Compostela University, Santiago de Compostela, Spain; CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain. 4. CIBER de Epidemiología y Salud Pública, CIBERESP, Madrid, Spain; Clinical Biostatistics Unit, Ramón y Cajal University Hospital, Research Institute Ramón y Cajal (IRYCIS), Madrid, Spain. 5. Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain. 6. Radiology Department, Ramón y Cajal University Hospital, Madrid, Spain. 7. Pneumology Department, Ramón y Cajal University Hospital, Madrid, Spain. 8. Radiotherapy Department, Ramón y Cajal University Hospital, Madrid, Spain. 9. Thoracic Surgery Department, Ramón y Cajal University Hospital, Madrid, Spain. 10. Medical and Gastrointestinal Oncology Department, Georges Pompidou Hospital, Paris, France. 11. Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medicine Department, Universidad de Alcalá, Research Institute Ramón y Cajal (IRYCIS), CIBER Oncology (CIBERONC), Madrid, Spain. 12. Medical Oncology Department, Ramón y Cajal University Hospital, Madrid, Spain; Medicine Department, Universidad de Alcalá, Research Institute Ramón y Cajal (IRYCIS), CIBER Oncology (CIBERONC), Madrid, Spain. Electronic address: pilargarridol@gmail.com.
Abstract
BACKGROUND: Radon gas is the leading cause of lung cancer in the nonsmoking population. The World Health Organization (WHO) recommends indoor concentrations of < 100 Bq/m³. Several molecular alterations have been described in non-small-cell lung cancer (NSCLC), mainly in nonsmokers, with no risk factors identified. We studied the role of indoor radon in NSCLC patients harboring specific driver alterations. PATIENTS AND METHODS: We assessed the radon concentration from EGFR-, BRAF-mutated (m), and ALK-rearranged (r) NSCLC patients measured by an alpha-track detector placed in their homes between September 2014 and August 2015. Clinical characteristics were collected prospectively, and pathologic samples were reviewed retrospectively. RESULTS: Forty-eight patients were included (36 EGFRm, 10 ALKr, 2 BRAFm). Median radon concentration was 104 Bq/m³ (IQR 69-160) overall, and was 96 Bq/m³ (42-915) for EGFRm, 116 (64-852) for ALKr, and 125 for BRAFm, with no significant differences. Twenty-seven patients (56%) had indoor radon above WHO recommendations, 8 (80%) of 10 ALKr, 2 (100%) of 2 BRAFm, and 17 (47%) of 36 EGFRm. CONCLUSION: The median indoor radon concentration was above the WHO recommendations, with no differences between EGFR, ALK, and BRAF patients. Concentrations above the WHO recommendations were most common with ALKr and BRAFm. These findings should be validated in larger studies.
BACKGROUND: Radon gas is the leading cause of lung cancer in the nonsmoking population. The World Health Organization (WHO) recommends indoor concentrations of < 100 Bq/m³. Several molecular alterations have been described in non-small-cell lung cancer (NSCLC), mainly in nonsmokers, with no risk factors identified. We studied the role of indoor radon in NSCLCpatients harboring specific driver alterations. PATIENTS AND METHODS: We assessed the radon concentration from EGFR-, BRAF-mutated (m), and ALK-rearranged (r) NSCLCpatients measured by an alpha-track detector placed in their homes between September 2014 and August 2015. Clinical characteristics were collected prospectively, and pathologic samples were reviewed retrospectively. RESULTS: Forty-eight patients were included (36 EGFRm, 10 ALKr, 2 BRAFm). Median radon concentration was 104 Bq/m³ (IQR 69-160) overall, and was 96 Bq/m³ (42-915) for EGFRm, 116 (64-852) for ALKr, and 125 for BRAFm, with no significant differences. Twenty-seven patients (56%) had indoor radon above WHO recommendations, 8 (80%) of 10 ALKr, 2 (100%) of 2 BRAFm, and 17 (47%) of 36 EGFRm. CONCLUSION: The median indoor radon concentration was above the WHO recommendations, with no differences between EGFR, ALK, and BRAFpatients. Concentrations above the WHO recommendations were most common with ALKr and BRAFm. These findings should be validated in larger studies.