Progressive Muscle Atrophy and Weakness After Treatment by Mantle Field Radiotherapy in Hodgkin Lymphoma Survivors

Leeuwen-Segarceanu, Elena M. van; Dorresteijn, Lucille D.A.; Pillen, Sigrid; Biesma, Douwe H.; Vogels, O.J.M.; Alfen, Nens van

doi:10.1016/j.ijrobp.2010.11.064

Cited by 39 publications

(43 citation statements)

References 24 publications

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“…In agreement with previous reports,10 12 15 there was a considerable time lag between the exposure to radiation and the development of the myopathy with mean latency of 15.8 years (range 2–45 years).…”

Section: Discussionsupporting

confidence: 93%

“…EMG study showed predominantly myopathic changes in the weak muscles, mainly paraspinal and periscapular muscles, as previously observed 11 12 14 15. In interpreting the electrophysiological findings, one should take into account that voluntary MUPs and recruitment pattern of the paraspinal muscles are less well characterised than limb muscles, possibly due to poor patient tolerance, difficulty in isolating motor units and also lack of consensus in precise localisation of spinal myotomal segments 20.…”

Section: Discussionsupporting

confidence: 56%

“…The previous published studies reported mainly the occurrence of RIM in Hodgkin's disease survivors10–15 and describe small case series with three to six patients11 12 14 or, if larger, included no pathological findings 15…”

Section: Discussionmentioning

confidence: 99%

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Clinical and laboratory findings of 21 patients with radiation-induced myopathy

Ghosh

Milone

2014

Journal of Neurology, Neurosurgery & Psychiatry

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 56%

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Clinical and laboratory findings of 21 patients with radiation-induced myopathy

Ghosh

Milone

2014

Journal of Neurology, Neurosurgery & Psychiatry

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“…The underlying mechanism of fatigue is multifactorial and is influenced by a number of different medical, psychosocial and behavioral factors. Treatment with radiotherapy and multiagent chemotherapy is known to cause direct insults to the CV system resulting in muscle weakness, CHD, left ventricular systolic dysfunction or pulmonary fibrosis [21,40,41]. These direct insults in combination with indirect lifestyle perturbations (e.g., physical inactivity, weight gain) can cause marked impairments in global CV function (VO 2peak ).…”

Section: • Valvular Heart Diseasementioning

confidence: 99%

Modulation of Cardiovascular Toxicity in Hodgkin Lymphoma: Potential Role and Mechanisms of Aerobic Training

Jones

2015

Future Cardiol.

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Hodgkin lymphoma (HL) outcomes have improved due to advances in cancer treatment. However, HL survivors remain at increased risk for cardiovascular (CV) morbidity and mortality related to the long-term cardiotoxicity of HL treatment, particularly anthracycline chemotherapy and mediastinal radiotherapy. The role of aerobic training for the prevention of CV disease in the general population has been well established. However the safety and efficacy of aerobic training on CV outcomes has not been well studied in HL survivors. The purpose of this paper is to provide an up-to-date summary of the treatment-related adverse CV effects in HL survivors, review the CV benefits of exercise and review the limited evidence on the potential CV benefit of aerobic training in HL survivors. Keywords• aerobic trainingHodgkin lymphoma (HL) is now a curable disease with a 5-year survival rate of 86%, and significant survival gains have been achieved through advances of multiagent chemotherapy and radiotherapy [1,2]. The specific treatment regimen for HL varies depending on the presenting stage and other prognostic factors, but anthracycline-based chemotherapy and radiotherapy have emerged as standard components of initial therapy for early stage HL [3]. Given the improved prognosis of HL survivors, the long-term consequences, particularly the cardiovascular (CV) late effects, of HL treatment are becoming an increasingly important aspect of long-term management of HL survivors.HL survivors are at markedly increased risk of cardiovascular disease (CVD) compared with the general population [4][5][6]. A robust series of studies indicate an increased risk of myocardial infarction, congestive heart failure and CVD-related mortality in HL survivors [7][8][9]. Of note, CVD is the leading nonmalignant cause of death among HL survivors, exceeded only by death related to HL or secondary malignancies [8]. The increased risk of CV events in HL survivors persists beyond 25 years from diagnosis, even when the background cardiac event rate in the general population starts to increase [10]. A major challenge in the management of HL patients is to develop strategies that minimize CV-related morbidity and mortality while maintaining the efficacy of anticancer regimens.Proposed strategies to minimize the CV events related to HL therapy include the use of modern irradiation techniques to reduce cardiac dose, omission of radiotherapy altogether, anthracycline dose reduction, use of liposomal anthracycline preparations and cardioprotective drugs such as iron chelators (e.g., dexrazoxane) [11][12][13][14]. There is concern, however, that some of the proposed strategies may diminish the anticancer efficacy of treatment [15,16]. In addition, these strategies have the potential to decrease, but not eliminate, the risk of CV toxicity related to HL treatment exposures.Physical activity is defined as any movement produced by skeletal muscles that results in energy expenditure, whereas exercise is defined as a regular regimen of physical activity performed for th...

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“…It is a rare form of delayed complication, manifesting decades after exposure to high-dose mantle-field radiotherapy. 39 It is characterized by weakness of neck extensor muscles resulting in an inability to extend the neck and a posture with the head flexed. The pathophysiology is unclear, but is thought to result from a combination of primary muscle damage and nerve damage.…”

Section: Developmental Hypoplasia/musculoskeletal Atrophymentioning

confidence: 99%

Current survivorship recommendations for patients with Hodgkin lymphoma: focus on late effects

2014

Hematology

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Long-term survivors of Hodgkin lymphoma (HL) are at an increased risk for a range of late complications, with subsequent malignant neoplasm and cardiovascular disease representing the 2 leading causes of death in these patients. Raising awareness, close follow-up, and adoption of selected early-detection and risk-reduction strategies may help to reduce the adverse impact of these late effects on patients. This chapter reviews known long-term complications of HL therapy, risk factors, and the timing of their occurrence. Where available, data on the efficacy of screening for selected late effects of HL are presented. Current evidence-based and consensus-based recommendations on follow-up of long-term HL survivors are also reviewed. As HL therapy evolves over time, late effects and implications on follow-up of patients treated in the contemporary era should be considered and opportunities for future research should be explored. Learning Objectives• To review the risk of and risk factors for late effects after HL therapy • To discuss data on the efficacy of screening strategies for selected late effects of HL • To summarize current follow-up recommendations for longterm HL survivors

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Progressive Muscle Atrophy and Weakness After Treatment by Mantle Field Radiotherapy in Hodgkin Lymphoma Survivors

Cited by 39 publications

References 24 publications

Clinical and laboratory findings of 21 patients with radiation-induced myopathy

Clinical and laboratory findings of 21 patients with radiation-induced myopathy

Modulation of Cardiovascular Toxicity in Hodgkin Lymphoma: Potential Role and Mechanisms of Aerobic Training

Current survivorship recommendations for patients with Hodgkin lymphoma: focus on late effects

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