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Treatment-related sequelae in Hodgkin’s lymphoma after mediastinal irradiation

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Abstract

Background

Many studies have investigated treatment-related sequelae in Hodgkin’s lymphoma (HL) in high-prevalence areas, but very few have been conducted in low-prevalence areas, including Taiwan and Japan.

Materials and methods

We retrospectively reviewed 101 HL patients who had received mediastinal radiotherapy between January 1997 and April 2013.

Results

Nine patients had cardiac events and nine patients developed second malignancies. Univariate analysis showed that bulkiness of disease was significantly associated with higher incidence of cardiac events (HR 7.70, 95% CI 1.60–38.00, p = 0.012). Disease stage and cumulative dose of radiotherapy were significantly correlated with incidence of radiation pneumonitis (HR 1.40, 95% CI 1.00–2.10, p = 0.043 and HR 1.10, 95% CI 1.00–1.20, p = 0.009, respectively). All cases of grade III–IV radiation pneumonitis happened in patients receiving a radiation dose higher than 35 Gy and developed within 4 months after radiotherapy.

Conclusions

Despite the similar incidence rates of treatment-related sequelae among HL survivors between areas with high and low prevalence of HL, cardiac events and second malignancies cannot be overlooked in HL survivors in low-prevalence areas.

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Acknowledgements

This work was supported by the Chang Gung Memorial Hospital at Linkou, Taiwan, under grants CMRPG3J0181, CMRPG3G1211, CMRPG3G1212, and CMRPG3G1213. The authors also thank Ms. Hsiao-Jung Tseng for statistical consultation, which was supported by grant for Biostatistical Center from Clinical Research, Chang Gung Memorial Hospital (CLRPG340599).

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Authors and Affiliations

  1. Department of Radiation Oncology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan

    Eric Yi-Liang Shen, Din-Li Tsan, Yin-yin Chiang & Shinn-Yn Lin

  2. Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, UK

    Eric Yi-Liang Shen

  3. Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Shinn-Yn Lin

  4. Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan

    Shinn-Yn Lin

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  1. Eric Yi-Liang Shen
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  2. Din-Li Tsan
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Correspondence to Yin-yin Chiang or Shinn-Yn Lin.

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Shen, E.YL., Tsan, DL., Chiang, Yy. et al. Treatment-related sequelae in Hodgkin’s lymphoma after mediastinal irradiation. Int J Hematol 115, 363–370 (2022). https://doi.org/10.1007/s12185-021-03264-x

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  • DOI: https://doi.org/10.1007/s12185-021-03264-x

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