Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma: Influence of Gonadal Hormone Exposure

Krul, Inge M; Winden, Annemieke W.J. Opstal‐van; Aleman, Berthe M.P.; Janus, Cécile P.M.; Eggermond, Anna M. van; Bruin, Marie L. De; Hauptmann, Michael; Krol, Augustinus D.G.; Schaapveld, Michael; Broeks, Annegien; Kooijman, Karen; Fase, Sandra; Lybeert, Marnix L.M.; Zijlstra, Josée M.; Maazen, R.W.M. van der; Kesminiene, Ausrele; Diallo, Ibrahima; Vathaire, Florent de; Russell, Nicola S.; Leeuwen, Flora E. van

doi:10.1016/j.ijrobp.2017.07.016

Cited by 37 publications

(36 citation statements)

References 31 publications

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“…The modification of breast cancer risk by hypogonadism and HRT, particularly in those with a history of chest irradiation, has been of particular interest. Recent studies suggest that, in hypogonadal individuals, HRT with combined estrogen and progesterone has no or only a moderately increased risk of breast cancer compared with those not receiving HRT; nevertheless, the risk remains lower than that in nonhypogonadal female survivors who also received chest irradiation . Further study is needed to investigate the risks and benefits of HRT in this population, particularly with regard to breast cancer risk as well as cardiovascular and bone mineral density outcomes.…”

Section: Interaction Of Cancer Therapy With Premorbid and Comorbid Comentioning

confidence: 99%

Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

Dixon

Bjornard

Alberts

et al. 2018

CA A Cancer J Clinicians

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The population of adult survivors of childhood cancer continues to grow as survival rates improve. Although it is well established that these survivors experience various complications and comorbidities related to their malignancy and treatment, this risk is modified by many factors that are not directly linked to their cancer history. Research evaluating the influence of patient-specific demographic and genetic factors, premorbid and comorbid conditions, health behaviors, and aging has identified additional risk factors that influence cancer treatment-related toxicity and possible targets for intervention in this population. Furthermore, although current long-term follow-up guidelines comprehensively address specific therapyrelated risks and provide screening recommendations, the risk profile of the population continues to evolve with ongoing modification of treatment strategies and the emergence of novel therapeutics. To address the multifactorial modifiers of cancer treatment-related health risk and evolving treatment approaches, a patient-centered and risk-adapted approach to care that often requires a multidisciplinary team approach, including medical and behavioral providers, is necessary for this population. CA Cancer J Clin 2018;68:133-152.

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Section: Interaction Of Cancer Therapy With Premorbid and Comorbid Comentioning

confidence: 99%

Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

Dixon

Bjornard

Alberts

et al. 2018

CA A Cancer J Clinicians

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“…The dose–response estimate will however be attenuated by known or unknown uncertainty in the dose estimation. (Quantification of this attenuation has been reported by our group in Krul et al [31] ). The situation is of course different when one wants to estimate the breast cancer risk for an individual patient based on her previously given treatment.…”

Section: Discussionmentioning

confidence: 84%

Retrospective methods to estimate radiation dose at the site of breast cancer development after Hodgkin lymphoma radiotherapy

Russell

Krul

Eggermond

et al. 2017

Clinical and Translational Radiation Oncology

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BackgroundAn increased risk of breast cancer following radiotherapy for Hodgkin lymphoma (HL) has now been robustly established. In order to estimate the dose–response relationship more accurately, and to aid clinical decision making, a retrospective estimation of the radiation dose delivered to the site of the subsequent breast cancer is required.MethodsFor 174 Dutch and 170 UK female patients with breast cancer following HL treatment, the 3-dimensional position of the breast cancer in the affected breast was determined and transferred onto a CT-based anthropomorphic phantom. Using a radiotherapy treatment planning system the dose distribution on the CT-based phantom was calculated for the 46 different radiation treatment field set-ups used in the study population. The estimated dose at the centre of the breast cancer, and a margin to reflect dose uncertainty were determined on the basis of the location of the tumour and the isodose lines from the treatment planning. We assessed inter-observer variation and for 47 patients we compared the results with a previously applied dosimetry method.ResultsThe estimated median point dose at the centre of the breast cancer location was 29.75 Gy (IQR 5.8–37.2), or about 75% of the prescribed radiotherapy dose. The median dose uncertainty range was 5.97 Gy. We observed an excellent inter-observer variation (ICC 0.89 (95% CI: 0.74–0.95)). The absolute agreement intra-class correlation coefficient (ICC) for inter-method variation was 0.59 (95% CI: 0.37–0.75), indicating (nearly) good agreement. There were no systematic differences in the dose estimates between observers or methods.ConclusionEstimates of the dose at the point of a subsequent breast cancer show good correlation between methods, but the retrospective nature of the estimates means that there is always some uncertainty to be accounted for.

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“…These institutions, referred to as data providers (DPs), provide data from 16 different institutional cohorts in total. Some of these DPs have previously collected their data, as part of a local fertility study [3,8,[17][18][19][20][21], while other DPs collect their data specifically during the PanCareLIFE project. All survivors included in the PanCareLIFE female fertility cohort study are treated between 1963 and 2014.…”

Section: Methodsmentioning

confidence: 99%

Fertility Among Female Survivors of Childhood, Adolescent, and Young Adult Cancer: Protocol for Two Pan-European Studies (PanCareLIFE) (Preprint)

Berg¹,

Dijk²,

Byrne³

et al. 2018

Preprint

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Breast Cancer Risk After Radiation Therapy for Hodgkin Lymphoma: Influence of Gonadal Hormone Exposure

Cited by 37 publications

References 31 publications

Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

Retrospective methods to estimate radiation dose at the site of breast cancer development after Hodgkin lymphoma radiotherapy

Fertility Among Female Survivors of Childhood, Adolescent, and Young Adult Cancer: Protocol for Two Pan-European Studies (PanCareLIFE) (Preprint)

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