Therapeutic radiation for lymphoma

Abstract

BACKGROUNDIonizing radiation has been used since the 1950s to treat a variety of cancers. Cancer patients who are treated with radiotherapy have shown increased risks for a variety of second malignancies, including mesothelioma, in several recent reports. The only existing study of Hodgkin lymphoma (HL) and subsequent mesothelioma had a short observation period.METHODSThe authors used Surveillance, Epidemiology, and End Results data over a 30‐year period to identify patients with HL and non‐Hodgkin lymphoma (NHL) who also were diagnosed with mesothelioma. Standardized incidence ratios (SIR) and absolute excess risks were calculated by sex and treatment modality for both types of lymphoma.RESULTSTwenty‐six patients were identified who had mesothelioma as second primaries based on 21,881 diagnoses of HL and 101,001 diagnoses of NHL. There was a statistically significant increase in mesothelioma (4 diagnoses; SIR, 6.59; 95% confidence interval [95% CI], 1.79–16.87) among men with HL who received radiation, but no women survivors were identified who had a diagnosis of mesothelioma. For NHL survivors, there was a nonsignificant excess of mesothelioma among men (SIR, 1.91; 95% CI, 0.77–3.93) and women (SIR, 3.75; 95% CI, 0.77–10.95) who had received radiation treatment. There were no increases among patients who were unirradiated.CONCLUSIONSMesothelioma rates for patients who had received radiotherapy were increased for survivors of HL and NHL. No increases were observed among the unirradiated. These findings and the existing body of supporting studies confirmed that radiotherapy is a cause of mesothelioma. Cancer 2007. © 2007 American Cancer Society.

Ionizing radiation: a risk factor for mesothelioma

“…Of 10,578 patients with HL and 26,266 with NHL who received radiation therapy between 1973 and 2003, 14 developed mesothelioma as a second primary cancer. Teta et al [31] reported a statistically significant increase in mesothelioma risk among men with HL who received radiation (four Only one study examined mesotheliomas in individuals with primary testicular cancer. Travis et al [35] In a retrospective cohort study, Brown et al [36] analyzed treatment-related second cancers in a cohort of 376,825 1-year breast cancer survivors who were diagnosed between 1943 and 2002 and were reported to cancer registries in Denmark, Finland, Norway, and Sweden.…”

“…Teta et al [31] recently examined the incidence of mesothelioma in patients in the SEER database who received therapeutic radiation for HL or NHL. Of 10,578 patients with HL and 26,266 with NHL who received radiation therapy between 1973 and 2003, 14 developed mesothelioma as a second primary cancer.…”

“…Cavazza et al [29] included patients with 17 different initial cancer types in SEER. Patients in the SEER registry with Hodgkin's lymphoma (HL) were included in studies by Neugut et al [30], Teta et al [31], and Hodgson et al [32]. Those with breast cancer were included in studies by Neugut et al [30] and Tward et al [33] and those with non-Hodgkin's lymphoma (NHL) were included in the studies by Tward et al [34] and Teta et al [31].…”

“…Hodgson et al [32] followed the HL cohort from SEER from 1970 to 2001, while Teta et al [31] followed them (and those with NHL) from 1973 to 2003. Hodgson et al [32] examined rates of second cancers in 18,862 5-year HL survivors from population-based registries in Denmark, Finland, Norway, and Sweden, as well as the US (using data from the SEER program).…”

“…Patients in the SEER registry with Hodgkin's lymphoma (HL) were included in studies by Neugut et al [30], Teta et al [31], and Hodgson et al [32]. Those with breast cancer were included in studies by Neugut et al [30] and Tward et al [33] and those with non-Hodgkin's lymphoma (NHL) were included in the studies by Tward et al [34] and Teta et al [31]. Although there is an overlap in subjects among these studies because several of these studies included patients with more than one primary cancer or included individuals from several registries, we have discussed them all below.…”