1521PD - Lung malignancies and second neoplasias in patients with Hodgkin’s acute lymphoma

Date 29 September 2012
Event ESMO Congress 2012
Session NSCLC - Immunotherapy, SCLC and Mesothelioma
Topics Complications of Treatment
Lymphomas
Lung and other Thoracic Tumours
Presenter Elena Almagro-Casado
Authors E. Almagro-Casado1, D. Pérez-Callejo2, A. López-González3, P. Ibeas1, A. Ruiz-Valdepeñas4, M. Palka4, C. Maximiano1, S. Mellor2, M. Méndez García1, M. Provencio Pulla5
  • 1Clinical Oncology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain, 28220 - Majadahonda/ES
  • 2Clinical Oncology, Hospital Puerta de Hierro Majadahonda, 28220 - Madrid/ES
  • 3Clinical Oncology, Hospital de León, Leon/ES
  • 4Medical Oncology, Hospital Universitario Puerta de Hierro Majadahonda, 28222 - Madrid/ES
  • 5Oncology, Hospital Puerta de Hierro Majadahonda, Madrid, Spain, 28220 - Majadahonda/ES

Abstract

Background

Patients with Hodgkińs Lymphoma (HL) have an increased risk of developing second neoplasias (SN). We analyzed and compared the long-term risk of developing thoracic malignancies (TM), (lung cancer or mesothelioma) to other neoplasias.

Patients and methods

We retrospectively analized from 1968 to 2011 a total of 514 patients with HL treated and monitored in our hospital. We reviewed as variables: date, age and initial staging at diagnosis, type of treatment (chemo, radiotherapy or combined), presence of bulky mass, date of SN diagnosis, type and staging of tumor (we included non- HL, leukemia, breast, colon, thyroid cancer and sarcoma) and overall survival (OS). The contrasts between proportions were performed using Chi-square test and the survival curves using the Kaplan-Meier method and logrank test.

Results

Out of 514 patients, SN occurred in 79 cases (16%). 24 (30,4%) patients developed lung cancer, 2 mesothelioma and 55(69,6%) other type of tumor. No differences were found between the average age at diagnosis of both HL or SN, 35,7 and 33,5 respectively (p = 0,56), although they were found between the relapsed time before the SN diagnosis (median of 16,4 years in TM and 9,7 in others (p = 0,03)). In the group of patients with TM, 21 (88%) of 24 patients were men (p = 0,001) whereas in the other tumors group no gender differences were found. 35 patients (44%) presented advanced stage (III or IV) at diagnosis, 7 (20%) with TM and 28 (80%) with other tumors (p = 0,074). Radiotherapy when compared with combined treatment was associated with increased risk of TM (RR = 2,5, IC95% 1,03-6,1) than other neoplasias. There were no differences between both groups when bulky mass was found. The OS from diagnosis of SN in TM and other tumors is 58% and 37% in one year and 61% and 42% in 5 (p = 0,54), with median of monitoring 1 year in TM and 1,5 in others.

Conclusions

Lung cancer and mesothelioma in patients with Hodgkin's lymphoma is much more prevalent in male patients according to our study. The treatment using radiotherapy leads to raised risk of lung cancer, compared to combined treatment. Although we did not find any difference in OS, we found differences between the relapsed time to diagnosis between both groups.

Disclosure

All authors have declared no conflicts of interest.