2ND CANCERS AFTER RADIOTHERAPY AND CHEMOTHERAPY FOR EARLY STAGES OF HODGKINS-DISEASE

  • 1 January 1983
    • journal article
    • research article
    • Vol. 71  (5) , 911-916
Abstract
In a population of 334 patients treated for Hodgkin''s disease by the European Organization for Research and Treatment of Cancer between 1964-1971, 21 patients with 2nd primary cancers (SC) were observed: 4 patients with acute leukemias, 3 with non-Hodgkin''s lymphomas and 14 with solid tumors. Time to SC ranged from 2-16 yr after initial treatment. The relative risk (RR) of acute leukemia for the patients with Hodgkin''s disease compared to the general population was 40 (P < 0.001). The RR of leukemia in patients treated by polychemotherapy-mechlorethamine, vincristine, procarbazine and prednisone-for relapse was 300 (P < 0.001). The RR of leukemia for those patients who did not experience a relapse was 14 (not significant). The RR of other SC in the overall group was 3.76 (P < 0.001). For patients whose relapses were treated by polychemotherapy the RR of SC, leukemia excepted, was 26 (P < 0.001), whereas for patients not treated by polychemotherapy for relapse the RR was slightly increased (RR = 3.67; P = 0.027). The cumulative proportions of acute leukemia at 10 yr were 0.7% in the no-relapse group and 2.7% in the polychemotherapy group. The cumulative proportions of other SC at 10 yr was 1.3% in the no-relapse group, 7.2% in the group of patients not treated by polychemotherapy after relapse, and 8.4% in the polychemotherapy group. The 1st important risk factor for developing an SC was polychemotherapy and the 2nd was age over 40 yr. Combination chemotherapy may be responsible for both acute leukemias and other SC.