Malignancies in German Thorotrast Patients and Estimated Tissue Dose

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Abstract
Up to now the names of about 6000 patients of the Thorotrast group and 6000 patients of the control group were obtained from records in different hospitals of West Germany. The control group consists of pseudorandomly selected patients from the same hospitals who were admitted at about the same time. The causes of death were ascertained from 1162 patients of the Thorotrast group and 883 persons of the control group, who died before they could be examined in our study, which began in 1968. Not included are those patients who died within 3 yr after Thorotrast injection respectively after hospitalization. The age at injection was 40 yr, and the survival time 17 yr on the average in the Thorotrast group. The recorded volumes of injected Thorotrast averaged 30 ml. The neoplastic diseases of the organs of interest in these groups had the following distribution (Thorotrast group to control group): liver 88/6; bone marrow 16/1; skeleton 2/0; lungs 25/24; spleen 0/0. To date (September 1975) we have examined clinically and biophysically 802 living Thorotrast patients and 622 members of the control group. The mean value of the age at injection in this Thorotrast group was 28 yr, and of the time from injection to first examination 26 yr. The mean injected volume of Thorotrast as calculated by the results of whole body counting was 22 ml. Since the beginning of these examinations 171 Thorotrast carriers have died. From the hospital records of these patients it is remarkable to note the excessive large number of liver tumors (51) and the high incidence of leukaemias (5). The patients who developed malignant neoplasias of the liver were injected on the average with 33 ml Thorotrast. Patients who suffered from leukaemia received only about 17 ml. Thorotrast. The accumulated radiation dose (mean exposure time 30 yr) in liver, spleen, lungs, bone marrow and skeleton are calculated from the results of the whole body measurements. Final conclusions concerning the frequency of late effects and its relation to the tissue dose depend on further results of follow up studies.

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