Laddaga Filomena Emanuela, Telegrafo Michele, Garzillo Carmela, Fiorentino Alba, Sardaro Angela, Martinotti Stefano, Moschetta Marco, Gaudio Francesco
Hematology and Cell Therapy Unit, IRCCS Istituto Tumori "Giovanni Paolo II", 70124 Bari, Italy.
Interdisciplinary Department of Medicine (DIM), Section of Radiology and Radiation Oncology, University of Bari, 70124 Bari, Italy.
Cancers (Basel). 2024 Dec 6;16(23):4091. doi: 10.3390/cancers16234091.
Hodgkin lymphoma (HL) treatment has dramatically improved, with high survival rates in early stages. However, long-term survivors face an increased risk of secondary cancers, particularly breast cancer (BC), which emerge as a leading cause of mortality decades after therapy. : This study explores the risk of BC and the toxic effects of radiation therapy (RT) in long-term HL survivors compared to age-matched high-risk women, including BRCA1 and BRCA2 mutation carriers. A prospective study was conducted on 62 women who had undergone chemotherapy and involved-field RT for HL, with MRI used to assess breast tissue changes. This study's primary endpoint was to analyze BC incidence in HL survivors, while secondary objectives focused on the analysis of background parenchymal enhancement (BPE) in irradiated areas. : The findings revealed a 5% incidence of BC in HL survivors, with 50% showing moderate or marked BPE, similar to that observed in high-risk BC controls. No significant differences in BPE distribution were found between the two groups. : The study highlights the long-term risk of BC in HL survivors and suggests that advanced RT techniques and targeted therapies may help reduce the incidence of secondary tumors. Future research should focus on understanding the genetic and biological mechanisms behind treatment-induced cancers.
霍奇金淋巴瘤（HL）的治疗有了显著改善，早期患者生存率较高。然而，长期存活者患继发性癌症的风险增加，尤其是乳腺癌（BC），它在治疗数十年后成为主要死亡原因。本研究探讨了与年龄匹配的高危女性（包括携带BRCA1和BRCA2突变者）相比，长期HL存活者患BC的风险以及放射治疗（RT）的毒性作用。对62例接受过HL化疗和累及野放疗的女性进行了一项前瞻性研究，采用磁共振成像（MRI）评估乳腺组织变化。本研究的主要终点是分析HL存活者的BC发病率，次要目标集中在分析放疗区域的背景实质强化（BPE）。研究结果显示，HL存活者中BC发病率为5%，50%表现为中度或明显BPE，与高危BC对照组观察到的情况相似。两组之间BPE分布无显著差异。该研究突出了HL存活者患BC的长期风险，并表明先进的放疗技术和靶向治疗可能有助于降低继发性肿瘤的发病率。未来的研究应集中于了解治疗诱导癌症背后的遗传和生物学机制。
