Journal article
Pancreatic cancer risk after treatment of Hodgkin lymphoma
Annals of oncology, Vol.25(10), pp.2073-2079
10/2014
DOI: 10.1093/annonc/mdu287
PMCID: PMC4176454
PMID: 25185241
Abstract
Although elevated risks of pancreatic cancer have been observed in long-term survivors of Hodgkin lymphoma (HL), no prior study has assessed the risk of second pancreatic cancer in relation to radiation dose and specific chemotherapeutic agents.
We conducted an international case–control study within a cohort of 19 882 HL survivors diagnosed from 1953 to 2003 including 36 cases and 70 matched controls.
Median ages at HL and pancreatic cancer diagnoses were 47 and 60.5 years, respectively; median time to pancreatic cancer was 19 years. Pancreatic cancer risk increased with increasing radiation dose to the pancreatic tumor location (Ptrend = 0.005) and increasing number of alkylating agent (AA)-containing cycles of chemotherapy (Ptrend = 0.008). The odds ratio (OR) for patients treated with both subdiaphragmatic radiation (≥10 Gy) and ≥6 AA-containing chemotherapy cycles (13 cases, 6 controls) compared with patients with neither treatment was 17.9 (95% confidence interval 3.5–158). The joint effect of these two treatments was significantly greater than additive (P = 0.041) and nonsignificantly greater than multiplicative (P = 0.29). Especially high risks were observed among patients receiving ≥8400 mg/m2 of procarbazine with nitrogen mustard or ≥3900 mg/m2 of cyclophosphamide.
Our study demonstrates for the first time that both radiotherapy and chemotherapy substantially increase pancreatic cancer risks among HL survivors treated in the past. These findings extend the range of nonhematologic cancers associated with chemotherapy and add to the evidence that the combination of radiotherapy and chemotherapy can lead to especially large risks.
Details
- Title: Subtitle
- Pancreatic cancer risk after treatment of Hodgkin lymphoma
- Creators
- G.M Dores - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, BethesdaR.E Curtis - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, BethesdaF.E van Leeuwen - Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, The NetherlandsM Stovall - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USAP Hall - Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, SwedenC.F Lynch - Department of Epidemiology, University of Iowa, Iowa City, USAS.A Smith - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USAR.E Weathers - Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston,USAH.H Storm - Cancer Prevention and Documentation, Danish Cancer Society, Copenhagen, DenmarkD.C Hodgson - University of TorontoR.A Kleinerman - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, BethesdaH Joensuu - Department of Oncology, Helsinki University Central Hospital, Helsinki, FinlandT.B Johannesen - Cancer Registry of Norway, Oslo, NorwayMichael Andersson - Copenhagen University HospitalE.J Holowaty - Dalla Lana School of Public Health, University of Toronto, Toronto,CanadaM Kaijser - Clinical Epidemiology Unit, Department of Medicine, Karolinska Institute, Stockholm, SwedenE Pukkala - Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki and School of Health Sciences, University of Tampere, Tampere, FinlandL Vaalavirta - Department of Oncology, Helsinki University Central Hospital, Helsinki, FinlandS.D Fossa - Department of Oncology, Oslo University Hospital and University of Oslo, Oslo, NorwayF Langmark - Cancer Registry of Norway, Oslo, NorwayL.B Travis - Department of Radiation Oncology, University of Rochester Medical Center, Rochester,USAJ.F Fraumeni - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, BethesdaB.M Aleman - Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The NetherlandsL.M Morton - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, BethesdaE.S Gilbert - Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda
- Resource Type
- Journal article
- Publication Details
- Annals of oncology, Vol.25(10), pp.2073-2079
- DOI
- 10.1093/annonc/mdu287
- PMID
- 25185241
- PMCID
- PMC4176454
- NLM abbreviation
- Ann Oncol
- ISSN
- 0923-7534
- eISSN
- 1569-8041
- Publisher
- Elsevier Ltd
- Grant note
- name: Intramural Research Program of the National Cancer Institute, National Institutes of Health; name: Department of Health and Human Services, and National Cancer Institute contracts to Cancer Care Ontario, award: N01-CP-31157; DOI: 10.13039/100008363, name: Danish Cancer Society, award: N01-CP-31019; name: Finnish Cancer Registry, award: N01-CP-31154; name: Information Management Services, Inc., award: N01-CP-31003; DOI: 10.13039/501100004047, name: Karolinska Institute, award: N01-CP-31156; DOI: 10.13039/100008893, name: University of Iowa, award: N01-CP-31155; DOI: 10.13039/100007313, name: The University of Texas MD Anderson Cancer Center, award: N02-CP-55503, N02-CP-31136; name: Lance Armstrong Foundation and the Dutch Cancer Society, award: NKI 04–3068
- Language
- English
- Date published
- 10/2014
- Academic Unit
- Epidemiology
- Record Identifier
- 9983995046802771
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