Clinical course of thoracic cancers in Hodgkin's disease survivors.
BACKGROUND
Hodgkin's disease survivors have a high risk of subsequently developing thoracic cancers. Our goal was to evaluate the prognosis and treatment outcomes of thoracic cancers after Hodgkin's disease.


METHODS
Thirty-three patients treated for Hodgkin's disease at Harvard-affiliated hospitals subsequently developed small-cell lung carcinoma, non-small-cell lung carcinoma (NSCLC) or mesothelioma. Information was obtained from medical records about the initial treatment for Hodgkin's disease, any salvage therapy, smoking history, and the stage, histology, treatment and survival for thoracic cancers.


RESULTS
Of the 33 patients, 29 (88%) had a history of radiotherapy to the thorax, 17 (52%) had received alkylating chemotherapy, and 24 (73%) had a known history of smoking. The median time between diagnosis of Hodgkin's disease and diagnosis of thoracic cancer was 17.3 years (range 1.2-27.9 years). Among patients with NSCLC and a known stage, 85% presented with stage III or stage IV disease. Among patients whose treatment details were available, 40% underwent surgery, 40% received radiotherapy and 65% received chemotherapy. The median survival was 9 months (range 1-47 months).


CONCLUSIONS
Most patients with thoracic cancers after Hodgkin's disease have a history of exposure to risk factors and present at an advanced stage. Patients with thoracic cancers after Hodgkin's disease have a poor survival.
Das
P
P
Department of Radiation Oncology, U.T. M.D. Anderson Cancer Center, Houston, TX 77030, USA. PrajDas@mdanderson.org
Ng
A K
AK
Stevenson
M A
MA
Mauch
P M
PM
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000453:epidemiology / Q000473:pathology; D018288:Carcinoma, Small Cell / Q000453:epidemiology / Q000473:pathology; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D008175:Lung Neoplasms / Q000453:epidemiology / Q000473:pathology; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008654:Mesothelioma / Q000453:epidemiology / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D012142:Respiratory Tract Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000503:physiopathology; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis