Valagussa P, Santoro A, Kenda R, Fossati Bellani F, Franchi F, Banfi A, Rilke F, Bonadonna G
Br Med J. 1980 Jan 26;280(6209):216-9. doi: 10.1136/bmj.280.6209.216.
A total of 764 patients with Hodgkin's disease treated with radiotherapy (RT) or chemotherapy or both were reviewed 3-186 months (median 43 months) after initial treatment to assess the incidence of second malignancies. Incidence of solid tumours and acute non-lymphoblastic leukaemia (ANLL) were calculated by a life-table method and percentages of patients affected derived from life-table plots. Within 10 years after initial treatment the overall incidence of second solid tumours was 7.3%, and over a comparable period 2.4% of patients developed ANLL. Solid tumours occurred only in patients given RT with or without adjuvant chemotherapy, and ANLL occurred only after treatment with MOPP (mustine, vincristine, procarbazine, and prednisolone) or modified MOPP regimens. Neither solid tumours nor ANLL occurred in patients given ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine). The highest incidence of leukaemia (5.4%) occurred after treatment with extensive RT plus (5.4%) occurred after treatment with extensive RT plus MOPP; hence the benefits of this approach in Hodgkin's disease must be weighed against its carcinogenic potential.
对764例接受放疗（RT）、化疗或两者联合治疗的霍奇金病患者进行了回顾性研究，这些患者在初始治疗后3 - 186个月（中位时间43个月）接受评估，以确定第二原发性恶性肿瘤的发生率。实体瘤和急性非淋巴细胞白血病（ANLL）的发生率通过生命表法计算，并从生命表图中得出受影响患者的百分比。在初始治疗后的10年内，第二原发性实体瘤的总体发生率为7.3%，在可比期间，2.4%的患者发生了ANLL。实体瘤仅发生在接受放疗（无论是否联合辅助化疗）的患者中，而ANLL仅在接受MOPP（氮芥、长春新碱、丙卡巴肼和泼尼松龙）或改良MOPP方案治疗后出现。接受ABVD（阿霉素、博来霉素、长春花碱和达卡巴嗪）治疗的患者既未发生实体瘤也未发生ANLL。白血病的最高发生率（5.4%）出现在广泛放疗加MOPP治疗后；因此，这种方法在霍奇金病中的益处必须与其致癌潜力相权衡。
