Lung cancer after Hodgkin's disease: A nested case-control study of the relation to treatment
Lung cancer after Hodgkin's disease: A nested case-control study of the relation to treatment
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DOI：
10.1200/jco.2001.19.6.1610
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发表时间：
2001-03-15
影响因子：
45.3
通讯作者：
Linch, DC
中科院分区：
文献类型：
--
作者：
Swerdlow, AJ;Schoemaker, MJ;Linch, DC
目的：调查的原因，肺癌的风险增加的患者谁有何杰金氏病，特别是治疗的关系，病人和方法：巢式病例对照研究进行了一个队列的5,519例何杰金氏病治疗在英国在1963年至1993年。对88例肺癌患者和176例对照者，从医院病例记录中提取治疗和其他危险因素的信息，并计算与这些因素相关的肺癌优势比。在使用氮芥、长春新碱、甲基苄肼，与未接受此治疗的患者相比，接受MOPP化疗的患者（相对危险度[RR] = 1.66; 95%可信区间[CI]，0.99 - 2.82），并且随着MOPP周期数的增加而增加（P = 0.07）。排除无法获得组织学证实的肺癌加强了这些相关性（RR = 2.41; 95% CI，1.33 - 4.51;任何MOPP P = 0.004，MOPP周期数趋势P = 0.007）。然而，在苯丁酸氮芥、长春碱、甲基苄肼和泼尼松治疗后，风险并没有增加。有证据表明，肺癌发生的放射治疗的风险仅限于组织学以外的腺癌。结论：结果表明，MOPP化疗可能会导致肺癌的风险升高，至少在某些亚组的患者。化疗在何杰金氏病后肺癌病因学中的作用值得进一步研究。(C)2001年，美国临床肿瘤学会。
Purpose: To investigate the causes of the raised risk of lung cancer in patients who have had Hodgkin's disease, and in particular the relationship to treatment.Patients and Methods: A nested case-control study was conducted within a cohort of 5,519 patients with Hodgkin's disease treated in Britain during 1963 through 1993. For 88 cases of lung cancer and 176 matched control subjects, information on treatment and other risk factors was extracted from hospital case-notes, and odds ratios for lung cancer in relation to these factors were calculated.Results: Risk of lung cancer was borderline significantly greater in patients treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy than those who did not receive this treatment (relative risk [RR] = 1.66; 95% confidence interval [CI], 0.99 to 2.82), and increased with number of cycles of MOPP (P =.07). Exclusion of lung cancers for which histologic confirmation was not available strengthened these associations (RR = 2.41; 95% CI, 1.33 to 4.51; P = .004 for any MOPP and P = 007 for trend with number of cycles of MOPP). Risks were not raised, however, after chlorambucil, vinblastine, procarbazine, and prednisone treatment. There was evidence that the raised risk of lung cancer occurring in relation to radiotherapy was restricted to histologies other than adenocarcinoma.Conclusion: The results suggest that MOPP chemotherapy may lead to elevated risk of lung cancer, at least in certain subgroups of patients. The role of chemotherapy in the etiology of lung cancer after Hodgkin's disease deserves further investigation. (C) 2001 by American Society of Clinical Oncology.