High Risk of Subsequent Neoplasms Continues With Extended Follow-Up of Childhood Hodgkin’s Disease: Report From the Late Effects Study Group

Bhatia, Smita; Yasui, Yutaka; Robison, Leslie L.; Birch, Jillian M; Bogue, Monica K.; Diller, Lisa; DeLaat, Cyndi; Fossati-Bellani, Franca; Morgan, Elaine; Oberlin, Odile; Reaman, Gregory; Ruymann, Frederick B.; Tersak, Jean M.; Meadows, Anna T.

doi:10.1200/jco.2003.11.059

Cited by 557 publications

(446 citation statements)

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“…8 Cohorts of Hodgkin's patients of any stage suggest that this difference is much higher. 8,[11][12][13][14][15][16][17]39 However, patients who relapse have a more pronounced risk of secondary malignancies according to a cohort study by Aleman and colleagues. 16 Therefore, the addition of radiotherapy which reduces the number of patients with relapse (who require more aggressive therapy) may contribute to a smaller overall risk difference than suggested by the cohorts who do not distinguish between relapsed and non-relapsed patients when evaluating the risk of radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

“…8,11 Risk factors for secondary malignancies and cardiac disease are the choice and dose of chemotherapy and radiotherapy. 8,[11][12][13][14][15][16][17] Unfortunately, long-term comparisons of combined modality treatment with chemotherapy alone (CT-alone) are difficult in cohorts of Hodgkin's survivors. Nonetheless, to avoid additional radiation-induced toxicity, chemotherapy-only treatment for patients with early stage HL has been advocated.…”

Section: Introductionmentioning

confidence: 99%

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Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Herbst¹,

Rehan²,

Brillant³

et al. 2009

Haematologica

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The online version of this article has a supplementary appendix.Combined modality treatment (CMT) of chemotherapy followed by localized radiotherapy is standard treatment for patients with early stage Hodgkin's lymphoma. However, the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. We thus performed a systematic review with meta-analysis of randomized controlled trials comparing chemotherapy alone with CMT in patients with early stage Hodgkin's lymphoma with respect to response rate, tumor control and overall survival (OS). We searched Medline, EMBASE and the Cochrane Library as well as conference proceedings from January 1980 to February 2009 for randomized controlled trials comparing chemotherapy alone versus the same chemotherapy regimen plus radiotherapy. Progression free survival and similar outcomes were analyzed together as tumor control. Effect measures used were hazard ratios for OS and tumor control as well as relative risks for complete response (CR). Meta-analyses were performed using RevMan5. Five randomized controlled trials involving 1,245 patients were included. The hazard ratio (HR) was 0.41 (95% confidence interval (CI) 0.25 to 0.66) for tumor control and 0.40 (95% CI 0.27 to 0.59) for OS for patients receiving CMT compared to chemotherapy alone. CR rates were similar between treatment groups. In sensitivity analyses another 6 trials were included that did not fulfill the inclusion criteria of our protocol but were considered relevant to the topic. These trials underlined the results of the main analysis. In conclusion, adding radiotherapy to chemotherapy improves tumor control and OS in patients with early stage Hodgkin's lymphoma.Key words: combined modality treatment, chemotherapy, Hodgkin's lymphoma.Citation: Herbst C, Rehan FA, Brillant C, Bohlius J, Skoetz N, Schulz H, Monsef I, Specht L, and Engert A. Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review. Haematologica. 2010.95:494-500. doi:10.3324/haematol.2009 This is an open-access paper. ABSTRACT therapy.The main objective of this systematic review was to compare chemotherapy alone with identical chemotherapy plus radiotherapy in patients with early stage HL with respect to overall survival, tumor control and complete response rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Herbst¹,

Rehan²,

Brillant³

et al. 2009

Haematologica

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“…The frequency of breast cancer after radiotherapy has been investigated in different studies. The frequency of breast cancer was reported to be 17% in 30 years (24) in a study performed in girls who received radiotherapy with a diagnosis of Hodgkin lymphoma in childhood and 14% at the age of 40 and 20% at the age of 45 in another study (25). While there are studies reporting that the risk increases if the age at the time of radiation therapy is younger than 21 years, other studies have reported that there is no difference in terms of the risk between receiving radiotherapy before adolescence and in the adolescence period.…”

Section: Breast Cancermentioning

confidence: 99%

“…While there are studies reporting that the risk increases if the age at the time of radiation therapy is younger than 21 years, other studies have reported that there is no difference in terms of the risk between receiving radiotherapy before adolescence and in the adolescence period. It is generally emphasized that the risk is increased 8 years after radiotherapy, these patients are diagnosed before the age of 40 and early diagnosis has a significant effect on survival (25)(26)(27)(28). In men who received RT to the chest area, the risk of breast cancer has not been shown to be increased.…”

Section: Breast Cancermentioning

confidence: 99%

“…Bhatia et al (38) found that t-MDS and AML developed in 11 of 578 patients in 5 years after treatment of Ewing sarcoma family of tumors of the bone in the Child Oncology Group study conducted between 1988 and 1992 and the cumulative risk was found to be 2%. In the same study, the cumulative frequency of secondary cancers was found to be increased 16 …”

Section: The Risk Of Myelodisplastic Syndrome and Acute Myeloid Leukemiamentioning

confidence: 99%

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Çocukluk çağı kanser sağ kalanlarında ikincil kanserler

Kebudi¹,

Özdemir²

2011

tpa

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Review Sum maryThe growing incidence of individuals surviving childhood cancer has increased the awareness of adverse long-term sequelae. One of the most unpleasant complications after cancer therapy is development of second malignant neoplasms. The risk of second malignancies is 2-3 times higher in childhood cancer survivors. The 20 year cumulative risk of secondary malignancies in 14193 chilhood cancer survivors followed for >5 years was 3.2 % . In this paper, the risk factors and development of improved therapies for second malignant neoplasms in childhood cancer survivors were reviewed. (Turk Arch Ped 2011; 46: 261-5)

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Medical Screening Participation in the Childhood Cancer Survivor Study

Cox

Hudson²,

Mertens³

et al. 2009

Arch Intern Med

Self Cite

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Purpose Despite their risk for serious late sequelae, childhood cancer survivors do not adhere to recommended medical screenings. We identified treatment, survivor, physician, and contextual factors that may influence survivors' adherence to recommended echocardiography and bone densitometry screening. Methods Structural equation modeling of data from the Childhood Cancer Survivor Study (CCSS); participants (N=838) were diagnosed and treated for pediatric malignancies between 1970 and 1986 . Results Survivors ( Mean age = 31 years; Mean age @ diagnosis = 10 years; Mean time since diagnosis = 21 years) at risk of cardiac sequelae (N=316) who reported more cancer-related visits (P = 0.01), having discussed heart disease with a physician (P ≤ 0.001), a sedentary lifestyle (P = 0.05), and less frequent health fears (P=0.05) were most likely to follow the recommended echocardiogram schedule (R2 = 23%). Survivors (Mean age=30 years; Mean age @ diagnosis = 9 years; Mean time since diagnosis = 21 years) at risk for osteoporosis (N=324) who reported more cancer-related visits (P = 0.05), were followed up at an oncology clinic (P = 0.01), had discussed osteoporosis with a physician (P ≤ 0.001), and had a lower BMI (P = 0.05) were most likely to adhere to the recommended bone density screening guidelines (R2 = 26%). Symptoms and motivation influenced screening frequency in both models. Conclusions Multiple factors influence survivors' adherence to screening recommendations. It is likely that tailored interventions would be more successful in encouraging recommended screening among childhood cancer survivors than will traditional health education approaches.

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High Risk of Subsequent Neoplasms Continues With Extended Follow-Up of Childhood Hodgkin’s Disease: Report From the Late Effects Study Group

Cited by 557 publications

References 41 publications

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Combined modality treatment improves tumor control and overall survival in patients with early stage Hodgkin's lymphoma: a systematic review

Çocukluk çağı kanser sağ kalanlarında ikincil kanserler

Medical Screening Participation in the Childhood Cancer Survivor Study

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