文献简介

出版社:Radiotherapy and Oncology

作  者:Laurien A. Daniëls, Augustinus D.G. Krol, Michael Schaapveld, Hein Putter, Patty M. Jansen, Erik W.A. Marijt, Flora E. van Leeuwen, Carien L. Creutzberg

编  号:

关键字:Hodgkin’s lymphoma; Radiation therapy; Secondary cancers; Skin cancers

年  份:2013   点击量:688

文献摘要


Purpose:
Survivors of Hodgkin’s lymphoma (HL) are at risk of secondary tumors. We investigated the risk 
of secondary skin cancers after radiotherapy compared to treatment without radiation and to an agematched population.
Material and methods:
We conducted a retrospective cohort study of 889 HL patients treated between 
1965 and 2005. Data on secondary skin cancers and treatment fields were retrieved. Incidence rates were compared to observed rates in the Dutch population.
Results:
318 skin cancers were diagnosed in 86 patients, showing significantly higher risks of skin cancers, 
the majority being BCC. The standardized incidence ratio (SIR) of BCC in HL survivors was significantly increased (SIR 5.2, 95% CI 4.0–6.6), especially in those aged <35 years at diagnosis (SIR 8.0, 95% CI 5.8–10.7). SIR increased with longer follow-up to 15.9 (95% CI 9.1–25.9) after 35 years, with 626 excess cases per 10,000 patients per year. Most (57%) skin cancers developed within the radiation fields, with significantly increased risk in patients treated with radiotherapy compared to chemotherapy alone (p = 0047, HR 275, 95% CI 101–7.45).
Conclusion:
Radiotherapy for HL is associated with a strongly increased long-term risk of secondary skin 
cancers, both compared to the general population and to treatment with chemotherapy alone.