Cardiac morbidity following modern treatment for Hodgkin lymphoma: Supra-additive cardiotoxicity of doxorubicin and radiation therapy
Cardiac morbidity following modern treatment for Hodgkin lymphoma: Supra-additive cardiotoxicity of doxorubicin and radiation therapy
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DOI：
10.1080/10428190802140873
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发表时间：
2008-01-01
影响因子：
2.6
通讯作者：
Hodgson, David C.
中科院分区：
文献类型：
--
作者：
Myrehaug, Sten;Pintilie, Melania;Hodgson, David C.
基于年龄和性别的霍奇金淋巴瘤（HL）患者接受基于阿霉素的化疗和放疗（RT）的心脏发病率估计很少。我们评估了615例HL患者因心脏病住院的风险，调整了年龄、性别、治疗、心脏危险因素和相互竞争的死亡原因。与一般人群相比，同时接受阿霉素和纵隔放疗的患者发生心脏疾病的风险最高（HR=2.77, p0.0001）。纵隔放射治疗不加化疗的风险也显著增加（HR=1.82, p=0.038）。对于40岁时接受阿霉素加纵隔放射治疗的女性和男性，15年心脏住院的估计发病率分别为7.3%和16.5%，比预期高5-15%。这些结果表明，包括阿霉素和纵隔放射治疗在内的HL治疗后发生临床重要心脏毒性的风险可能大于先前单独接受放射治疗的患者。
Age- and sex-specific estimates of the rate of cardiac morbidity among Hodgkin lymphoma (HL) patients treated with doxorubicin-based chemotherapy and radiation therapy (RT) are scarce. We evaluated the risk of hospital admission for cardiac disease in 615 HL patients, adjusting for age, sex, treatment, cardiac risk factors and competing causes of death. Compared with the general population, the risk of cardiac morbidity was highest among patients treated with both doxorubicin and mediastinal RT (HR=2.77, p0.0001). Mediastinal RT without chemotherapy also significantly increased the risk (HR=1.82, p=0.038). For females and males treated with doxorubicin plus mediastinal RT at age 40, the estimated 15-year incidence rate of cardiac hospitalisation were 7.3% and 16.5%, respectively, rates 5-15% higher than expected. These results suggest that the risk of clinically important cardiac toxicity following HL treatment that includes both doxorubicin and mediastinal RT may be greater than that reported in prior studies of patients treated with RT alone.