Hospital Medicine, Virginia Commonwealth University, Richmond, VA; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.
University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD; Hematology and Medical Oncology, Taussig Cancer Center, Cleveland Clinic, Cleveland, OH.
Clin Lung Cancer. 2022 Dec;23(8):e510-e518. doi: 10.1016/j.cllc.2022.08.003. Epub 2022 Aug 7.
There is insufficient data regarding the incidence rate of secondary lung cancer among Hodgkin lymphoma (HL) survivors and the predisposing factors.
We analyzed the data from the cohort of patients who had HL between 1973 and 2015 using the Surveillance Epidemiology and End Results database (SEER). Data on patient's age, gender, year of diagnosis with HL, Ann-Arbor stage, Histology, racial groups, date of last follow-up, date of death, and treatment modalities were collected.
We identified a total of 56,856 patients with HL; of those, 862 had secondary lung cancer, with an incidence rate of 157 (95%CI: 147-168) per 100,000 person-years. The median overall survival from time of HL diagnosis for those with secondary lung cancer was 12.1 years (95% CI: 10.7-13) compared to 27.1 years (95% CI: 26.5-27.6) for those who did not develop lung cancer (log-rank P-value of <.01). After propensity score weighting, radiation therapy was associated with a higher risk of secondary lung cancer (hazard ratio (HR): 1.23, 95% CI: 1.002-1.55) with a P-value of 0.048. Older age at the time of HL diagnosis and male gender were associated with higher risk, with an HR of 1.07 (95% CI 1.062-1.073) and an HR of 1.602 (95% CI 1.33-1.94), respectively. Furthermore, chemotherapy increased the risk only among older age groups.
Older age at the time of HL diagnosis, male gender, radiation therapy, and chemotherapy only among older age groups were associated with higher risk for secondary lung cancer, with 50% of the cases occurring within 9.1 years following HL diagnosis.
关于霍奇金淋巴瘤（HL）幸存者中继发性肺癌的发病率和相关诱发因素的数据有限。
我们使用监测、流行病学和最终结果（SEER）数据库对 1973 年至 2015 年间患有 HL 的患者队列进行数据分析。收集了患者年龄、性别、HL 诊断年份、Ann-Arbor 分期、组织学、种族群体、最后一次随访日期、死亡日期和治疗方式的数据。
我们共确定了 56856 例 HL 患者；其中 862 例发生继发性肺癌，发病率为 157（95%CI：147-168）/100,000 人年。发生继发性肺癌的患者从 HL 诊断到死亡的中位总生存期为 12.1 年（95%CI：10.7-13），而未发生肺癌的患者为 27.1 年（95%CI：26.5-27.6）（对数秩检验 P<0.01）。在倾向评分加权后，放疗与继发性肺癌风险增加相关（风险比（HR）：1.23，95%CI：1.002-1.55），P 值为 0.048。HL 诊断时年龄较大和男性与较高的风险相关，HR 分别为 1.07（95%CI 1.062-1.073）和 1.602（95%CI 1.33-1.94）。此外，化疗仅增加老年患者的风险。
HL 诊断时年龄较大、男性、放疗以及仅在老年患者中进行化疗与继发性肺癌风险增加相关，50%的病例发生在 HL 诊断后 9.1 年内。
