Centre for Children's Cancer and Blood Disorders, Sydney Children's Hospital, Randwick.
Department of Oncology, The Children's Hospital, Westmead.
Ann Oncol. 2011 Dec;22(12):2569-2574. doi: 10.1093/annonc/mdr013. Epub 2011 Mar 10.
We assessed the risk of developing second malignancies in children treated for Hodgkin's lymphoma (HL), the majority of whom received chemotherapy only.
The development of second malignancies in children with HL, treated between 1960 and 1999, was assessed. Results were obtained by both chart review and linkage with a centralized cancer registry. Tumor incidence was compared for patients treated with and without radiotherapy (RT) and with the general population. Risk factors for developing second tumors were assessed by multivariate analysis.
Of 142 childhood HL patients, 63 had received RT and 79 had not. Overall survival was similar for both groups. Fourteen patients developed second solid tumors, 12 who had received RT and 2 treated with chemotherapy only (P <0.001), with a 30-year cumulative incidence of 24.7% [95% confidence interval (CI) 7.27-47.4] and 5.8% (95% CI 0-58.9), respectively (P = 0.01). The standardized incidence ratio for second solid tumors was 236 (95% CI 112.2-359.0) versus 43.6 (95% CI 0-103.9), respectively. Multivariate analysis showed treatment with RT was the only significant risks factor for developing second solid tumors.
Children with HL without RT have a substantially lower incidence of second tumors than those treated with RT.
我们评估了接受霍奇金淋巴瘤（HL）治疗的儿童发生第二恶性肿瘤的风险，其中大多数仅接受化疗。
评估了 1960 年至 1999 年期间接受 HL 治疗的儿童的第二恶性肿瘤的发展情况。通过病历回顾和与集中癌症登记处的链接获得结果。通过多变量分析评估了未接受和接受放射治疗（RT）以及与一般人群相比的肿瘤发生率。
在 142 例儿童 HL 患者中，63 例接受了 RT，79 例未接受 RT。两组患者的总生存率相似。有 14 名患者发生了第二实体肿瘤，其中 12 例接受了 RT，2 例仅接受了化疗（P<0.001），30 年累积发生率分别为 24.7%（95%CI7.27-47.4）和 5.8%（95%CI0-58.9）（P=0.01）。第二实体肿瘤的标准化发病率比分别为 236（95%CI112.2-359.0）和 43.6（95%CI0-103.9）。多变量分析表明，接受 RT 是发生第二实体肿瘤的唯一显著危险因素。
未接受 RT 的 HL 患儿发生第二肿瘤的发生率明显低于接受 RT 的患儿。
