Pulmonary outcomes in patients with Hodgkin lymphoma treated with involved field radiation

Venkatramani, Rajkumar; Kamath, Sunil; Wong, Kenneth; Olch, Arthur J.; Malvar, Jemily; Sposto, Richard; Goodarzian, Fariba; Freyer, David R.; Keens, Thomas G.; Mascarenhas, Leo

doi:10.1002/pbc.24969

Cited by 19 publications

(11 citation statements)

References 27 publications

(35 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Notably, no subjects in our cohort received TBI and only one subject was treated with whole lung irradiation, both of which have been associated with late adverse pulmonary outcomes. 16, 27, 30 While 93% of adolescent subjects in our cohort reported respiratory symptoms in the past month, only half (7/14) reported frequent symptoms (daily or several days of the week). Adolescent questionnaires did not ask about self-reported chronic respiratory symptoms, preventing a direct comparison with parental-reported data.…”

Section: Discussionmentioning

confidence: 79%

See 1 more Smart Citation

Long-term Pulmonary Outcomes in Pediatric Survivors of High-risk Neuroblastoma

Stone

Friedman

Worgall

et al. 2017

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Background Children with high-risk neuroblastoma (NB) are exposed to multimodality therapies early in life and survivors confront late therapy-related toxicities. This study assessed respiratory symptoms, pulmonary function tests (PFTs), and risk factors for abnormalities among survivors. Methods High-risk NB survivors followed in the Long-term Follow-up clinic at Memorial Sloan Kettering Cancer Center were enrolled. Self-administered symptom questionnaires were completed. Medical records were reviewed for treatment information and co-morbidities. PFTs included spirometry, plethysmography, and diffusion capacity of the lung for carbon monoxide (DLCO). Results Thirty nine survivors participated (median age at study: 11.4 years; median age at diagnosis: 2.3 years; median time since completion of therapy: 5.5 years). Chronic respiratory symptoms were reported for 33%. PFT abnormalities were identified in 79% and included low forced expiratory volume in 1 second (FEV1) (38%), decreased total lung capacity (TLC) (44%), and abnormal DLCO (67%). PFT abnormalities were mostly mild to moderate. Mean forced vital capacity, forced expiratory volume in 1 second, and total lung capacity were normal and mean DLCO was mildly abnormal. Risks included thoracic surgery, chest radiation therapy (RT), thoracic surgery plus chest RT, and shorter time since completion of therapy (p<0.05). Conclusions While respiratory abnormalities were common, they were mostly mild or moderate. Continued pulmonary surveillance of this at-risk population is warranted.

show abstract

Section: Discussionmentioning

confidence: 79%

“…3, 9–27 Late respiratory complications of anti-neoplastic treatments have been described in children. 8–23, 25 Additionally, studies have suggested that exposure to some cancer therapies very early in life may increase the risk for long-term sequelae.…”

Section: Introductionmentioning

confidence: 99%

Long-term Pulmonary Outcomes in Pediatric Survivors of High-risk Neuroblastoma

Stone

Friedman

Worgall

et al. 2017

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

show abstract

“…Older age [26], the presence of cardiac comorbidities [27] and tumor location in the inferior part of the lung [10,28] were found to increase the risk of lung toxicity significantly. Aging was also associated with worse pulmonary outcome in a pediatric and teenagers cohort [29]. In our previous study [9] on pulmonary complications after HL therapy in a subset of the present patient cohort, the highdose (30 Gy) volume in the left lung appeared to be a better predictor of toxicity than the high dose volume in both lungs.…”

Section: Discussionmentioning

confidence: 87%

Modeling the risk of radiation-induced lung fibrosis: Irradiated heart tissue is as important as irradiated lung

Cella

D’Avino

Palma

et al. 2015

Radiotherapy and Oncology

View full text Add to dashboard Cite

“…Survivors of HL are at increased risk of multiple non-cancer morbidities (Aleman et al, 2007;Galper et al, 2011;Schellong et al, 2010;Adams et al, 2004;De Bruin et al, 2009b;Bowers et al, 2005;De et al, 2014;Venkatramini et al, 2014;Oguz et al, 2007;Sklar et al, 2000;Krull et al, 2012;De Bruin et al, 2008;Behringer et al, 2013;van der Kaaij et al, 2012;Daniels et al, 2014;Ruffer et al, 2003;Zebrack et al, 2002;Oerlemans et al, 2011). We have described the number of TYA HL survivors who experienced severe late effects necessitating inpatient hospitalisation and interpreted this as a surrogate marker of morbidity.…”

Section: Discussionmentioning

confidence: 99%

Late mortality, secondary malignancy and hospitalisation in teenage and young adult survivors of Hodgkin lymphoma: report of the Childhood/Adolescent/Young Adult Cancer Survivors Research Program and the BC Cancer Agency Centre for Lymphoid Cancer

Bhuller

Zhang

et al. 2016

Br J Haematol

View full text Add to dashboard Cite

Late complications affecting Hodgkin lymphoma (HL) survivors are well described in paediatric and adult-based publications. This study determined the late morbidity and mortality risk for 442 teenage and young adult (TYAs) 5-year HL survivors, diagnosed at 15-24 years of age between 1970 and 1999, identified from the British Columbia Cancer Registry. Treatment details were abstracted from charts. Survivors and a matched comparison cohort were linked to provincial administrative health datasets until December 2006 and regression analysis was performed, providing risk ratios regarding mortality, secondary malignancy and morbidity causing hospitalisation. Sixty (13·6%) survivors experienced late mortality with excess deaths from secondary cancer [standardised mortality ratio (SMR) 18·6; 95% confidence interval (CI) 11-29·4] and non-malignant disease (SMR 3·6; 95% CI 2·2-5·5). Excess secondary cancers (standardised incidence ratio 7·8; 95% CI 5·6-10·5) were associated with radiotherapy [Hazard ratio (HR) 2·7; 95% CI 1-7·7] and female gender (HR 1·8; 95% CI 1-3·4). Of 281 survivors treated between 1981 and 1999, 143 (51%) had morbidity resulting in hospitalisation (relative risk 1·45; 95% CI 1·22-1·73). Hospitalisation significantly increased with combined modality therapy, chemotherapy alone and recent treatment era. TYA HL survivors have excess risk of mortality and secondary malignancy continuing 30 years from diagnosis. Radiotherapy is associated with secondary malignancy and current response-adapted protocols attempt to minimise exposure, but late morbidity causing hospitalisation remains significant.

show abstract

Pulmonary outcomes in patients with Hodgkin lymphoma treated with involved field radiation

Abstract: In survivors of pediatric HL, involved field irradiation was accompanied by a low prevalence of pulmonary symptoms but substantial subclinical dysfunction. Older age at irradiation was associated with worse pulmonary outcomes.

Cited by 19 publications

References 27 publications

Long-term Pulmonary Outcomes in Pediatric Survivors of High-risk Neuroblastoma

Long-term Pulmonary Outcomes in Pediatric Survivors of High-risk Neuroblastoma

Modeling the risk of radiation-induced lung fibrosis: Irradiated heart tissue is as important as irradiated lung

Late mortality, secondary malignancy and hospitalisation in teenage and young adult survivors of Hodgkin lymphoma: report of the Childhood/Adolescent/Young Adult Cancer Survivors Research Program and the BC Cancer Agency Centre for Lymphoid Cancer

Contact Info

Product

Resources

About