Harvard Radiation Oncology Program, Department of Radiation Oncology, Brigham and Women's Hospital, Boston, MA 02115, USA.
Ann Oncol. 2012 Jul;23(7):1813-8. doi: 10.1093/annonc/mdr551. Epub 2011 Nov 21.
Hodgkin lymphoma (HL) survivors have an increased risk of secondary malignancies. We analyzed outcomes in patients with lung cancers following HL treatment.
Cases of thoracic malignancies were retrospectively identified from a multi-institutional database of 1976 patients treated for HL from 1969 to 2007. Data regarding risk factors, disease characteristics and outcomes were obtained from medical records.
Lung malignancies were identified in 55 patients a median of 19.5 years after initial HL therapy. Thirty-one patients (56%) had a >10 pack-year history of tobacco use, 48 (87%) received thoracic irradiation and 26 (47%) received alkylating chemotherapy. Of the 42 patients with known stage at lung cancer diagnosis, 23 (55%) were stage IV and 5 (12%) were stage III. The method of lung cancer detection was known for 35 patients; of these, 12 (34%) were detected incidentally. Median survival time after diagnosis was 10 months for all 55 patients. Median survival time for patients with incidentally detected tumors has not been reached with a median follow-up of 39 months.
Lung malignancies diagnosed in patients successfully treated for HL generally have a dismal prognosis. However, a subset of patients diagnosed incidentally may have potentially curable disease.
霍奇金淋巴瘤（HL）幸存者发生继发性恶性肿瘤的风险增加。我们分析了 HL 治疗后肺癌患者的结局。
从 1969 年至 2007 年治疗 HL 的多机构数据库中回顾性确定了胸部恶性肿瘤的病例。从病历中获得了有关危险因素、疾病特征和结局的数据。
在初始 HL 治疗后中位数为 19.5 年时，发现了 55 例肺癌。31 例患者（56%）有 >10 包年的吸烟史，48 例（87%）接受了胸部放疗，26 例（47%）接受了烷化剂化疗。在已知肺癌诊断时分期的 42 例患者中，23 例（55%）为 IV 期，5 例（12%）为 III 期。35 例已知肺癌检测方法的患者中，有 12 例（34%）为偶然发现。所有 55 例患者的中位总生存期为 10 个月。中位随访 39 个月时，偶然发现肿瘤的患者的中位生存时间尚未达到。
成功治疗 HL 的患者中诊断出的肺癌一般预后不良。然而，偶然发现的患者亚组可能患有潜在可治愈的疾病。
