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Lung cancer after treatment for Hodgkin's lymphoma: a systematic review.

Abstract

Developments in modern chemotherapy and radiotherapy mean that most patients with Hodgkin's lymphoma can now be cured. However, the long-term effects of anticancer treatment include an increased risk of a second malignant disease. We have done a systematic review of studies reporting long-term complications of the treatment of Hodgkin's lymphoma published in English since 1985. These studies show that risk of lung cancer is significantly increased in patients treated for Hodgkin's lymphoma, with a reported mean relative risk of 2.6-7.0 and a significantly increased absolute excess risk. The absolute excess risk increases with time from treatment, for as long as 20-25 years, and is highest in patients treated at age 45 years or older. Both chemotherapy and radiotherapy contribute to the risk, and evidence suggests that the effects are additive. Cigarette smoking seems to multiply the risk associated with both chemotherapy and radiotherapy. In the high-risk group of patients, 50-150 patients per 1000 are expected to develop lung cancer by 10-20 years after treatment. The role of screening in this group of patients has not yet been assessed, but an international study combining CT with genomic and proteomic assessment is planned.

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  • Authors+Show Affiliations

    ,

    Cancer Research UK Department of Medical Oncology, Christie Hospital NHS Trust, Manchester M20 4BX, UK. paul.lorigan@man.ac.uk

    , ,

    Source

    The Lancet. Oncology 6:10 2005 Oct pg 773-9

    MeSH

    Adolescent
    Adult
    Age Factors
    Antineoplastic Agents
    Child
    Child, Preschool
    Combined Modality Therapy
    Female
    Follow-Up Studies
    Hodgkin Disease
    Humans
    Infant
    Lung Neoplasms
    Male
    Middle Aged
    Neoplasms, Radiation-Induced
    Neoplasms, Second Primary
    Risk Factors
    Smoking

    Pub Type(s)

    Journal Article
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    16198983

    Citation

    Lorigan, Paul, et al. "Lung Cancer After Treatment for Hodgkin's Lymphoma: a Systematic Review." The Lancet. Oncology, vol. 6, no. 10, 2005, pp. 773-9.
    Lorigan P, Radford J, Howell A, et al. Lung cancer after treatment for Hodgkin's lymphoma: a systematic review. Lancet Oncol. 2005;6(10):773-9.
    Lorigan, P., Radford, J., Howell, A., & Thatcher, N. (2005). Lung cancer after treatment for Hodgkin's lymphoma: a systematic review. The Lancet. Oncology, 6(10), pp. 773-9.
    Lorigan P, et al. Lung Cancer After Treatment for Hodgkin's Lymphoma: a Systematic Review. Lancet Oncol. 2005;6(10):773-9. PubMed PMID: 16198983.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Lung cancer after treatment for Hodgkin's lymphoma: a systematic review. AU - Lorigan,Paul, AU - Radford,John, AU - Howell,Anthony, AU - Thatcher,Nick, PY - 2005/10/4/pubmed PY - 2005/10/27/medline PY - 2005/10/4/entrez SP - 773 EP - 9 JF - The Lancet. Oncology JO - Lancet Oncol. VL - 6 IS - 10 N2 - Developments in modern chemotherapy and radiotherapy mean that most patients with Hodgkin's lymphoma can now be cured. However, the long-term effects of anticancer treatment include an increased risk of a second malignant disease. We have done a systematic review of studies reporting long-term complications of the treatment of Hodgkin's lymphoma published in English since 1985. These studies show that risk of lung cancer is significantly increased in patients treated for Hodgkin's lymphoma, with a reported mean relative risk of 2.6-7.0 and a significantly increased absolute excess risk. The absolute excess risk increases with time from treatment, for as long as 20-25 years, and is highest in patients treated at age 45 years or older. Both chemotherapy and radiotherapy contribute to the risk, and evidence suggests that the effects are additive. Cigarette smoking seems to multiply the risk associated with both chemotherapy and radiotherapy. In the high-risk group of patients, 50-150 patients per 1000 are expected to develop lung cancer by 10-20 years after treatment. The role of screening in this group of patients has not yet been assessed, but an international study combining CT with genomic and proteomic assessment is planned. SN - 1470-2045 UR - https://www.unboundmedicine.com/medline/citation/16198983/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S1470-2045(05)70387-9 DB - PRIME DP - Unbound Medicine ER -