Boivin J F, Hutchison G B, Lubin J H, Mauch P
Department of Epidemiology and Biostatistics, McGill University, Montréal, Canada.
Cancer. 1992 Mar 1;69(5):1241-7. doi: 10.1002/cncr.2820690528.
The authors conducted a follow-up study of the association between mediastinal irradiation, chemotherapy, and mortality from coronary artery disease in 4665 patients treated for Hodgkin's disease. Study subjects were followed after the diagnosis of Hodgkin's disease until death or the closing date of the study. The average duration of follow-up was 7 years; 2415 patients died, and 124 cases of coronary artery disease were identified from death certificates, including 68 cases of acute myocardial infarction. The age-adjusted relative risks (RR) of death with any coronary artery disease after mediastinal irradiation and after chemotherapy were 1.87 (95% confidence interval [CI], 0.92 to 3.80) and 1.28 (CI, 0.77 to 2.15), respectively. A significantly increased risk of death in the subcategory myocardial infarction was observed after mediastinal irradiation (RR, 2.56; CI, 1.11 to 5.93) but not after chemotherapy (RR, 0.97; CI, 0.53 to 1.77). These results support the hypothesis that radiation therapy to the mediastinum increases the risk of coronary artery disease.
作者对4665例接受霍奇金病治疗的患者进行了一项随访研究，以探讨纵隔照射、化疗与冠状动脉疾病死亡率之间的关联。研究对象在被诊断为霍奇金病后进行随访，直至死亡或研究结束日期。平均随访时间为7年；2415例患者死亡，从死亡证明中确定了124例冠状动脉疾病病例，其中包括68例急性心肌梗死。纵隔照射和化疗后发生任何冠状动脉疾病的年龄调整相对风险（RR）分别为1.87（95%置信区间[CI]，0.92至3.80）和1.28（CI，0.77至2.15）。纵隔照射后观察到心肌梗死亚类的死亡风险显著增加（RR，2.56；CI，1.11至5.93），但化疗后未观察到（RR，0.97；CI，0.53至1.77）。这些结果支持纵隔放射治疗会增加冠状动脉疾病风险这一假设。
