Konference: 2008 33st Congress ESMO - účast ČR
Kategorie: Maligní lymfomy a leukémie
Téma: Hematological malignancies
Číslo abstraktu: 742P
Autoři: MUDr. Jiří Vyskočil; MUDr. Markéta Palácová; L. Komolýkova; prof. MUDr. Rostislav Vyzula, CSc.
Background: Second malignancies kill more patients with HD
than the disease itself. In the majority of published studies, the
observed and expected number of cancers were compared in the cohort
with use of age-specific national incidence rate. The aim of our
study was to quantify RR of SM in patients treated by ‘‘risk RT’’
(see below) or ‘‘risk RT’’ + CT in comparison with patients treated
only with CT. We wanted to assess if there is a reason to provide
different follow up for these two different groups of patients. As
a ‘‘risk RT’’ was considered: RT to mediastinal or axillary field
for breast cancer, RT to neck for thyroid cancer, RT to upper
abdomen for stomach cancer, RT to
abdomen or paraaortic nodes for colon cancer, RT to pelvis for gynecologic malignancies.
Methods: A total of 895 patients were treated for HD in MOU between 1967 and 1995, 507 men and 388 women. All patients who survived Ł 1 year after HD diagnosis were excluded. 353 patients were treated only by RT, 324 only by CT and 208 by RT+CT. Median age at the time of diagnosis was 34 years and 54 years at the time of diagnosis of secondary cancer. Median follow-up was 12 years. We observed 140 cases of secondary cancers in 115 PT.
Results: Observed RR was for: breast cancer 4.92, lung cancer 1.34, colon cancer 8.76, stomach cancer 2.41, thyroid cancer 1.52, gynecologic cancer 2.19. Conclusion: The RR for solid tumors as secondary malignancies increased with the time of follow-up. Treatment with ‘‘risk RT’’ increases RR of breast cancer, colon cancer, gynecologic cancer and, slightly, thyroid cancer. Therefore this group of patients should be offered more intensive follow-up: PT with higher RR of breast cancer mammography (or ultrasonography) every year, with the first examination no later than 10 eyars after the treatment, PT with higher RR of colorectal cancer yearly haemocult examination, coloscopy no later than 10 years after RT and then every 2-3 years, PT with higher RR of gynecological malignancies yearly gynecologic examination with ovary ultrasonography no later than 10 years after RT.
abdomen or paraaortic nodes for colon cancer, RT to pelvis for gynecologic malignancies.
Methods: A total of 895 patients were treated for HD in MOU between 1967 and 1995, 507 men and 388 women. All patients who survived Ł 1 year after HD diagnosis were excluded. 353 patients were treated only by RT, 324 only by CT and 208 by RT+CT. Median age at the time of diagnosis was 34 years and 54 years at the time of diagnosis of secondary cancer. Median follow-up was 12 years. We observed 140 cases of secondary cancers in 115 PT.
Results: Observed RR was for: breast cancer 4.92, lung cancer 1.34, colon cancer 8.76, stomach cancer 2.41, thyroid cancer 1.52, gynecologic cancer 2.19. Conclusion: The RR for solid tumors as secondary malignancies increased with the time of follow-up. Treatment with ‘‘risk RT’’ increases RR of breast cancer, colon cancer, gynecologic cancer and, slightly, thyroid cancer. Therefore this group of patients should be offered more intensive follow-up: PT with higher RR of breast cancer mammography (or ultrasonography) every year, with the first examination no later than 10 eyars after the treatment, PT with higher RR of colorectal cancer yearly haemocult examination, coloscopy no later than 10 years after RT and then every 2-3 years, PT with higher RR of gynecological malignancies yearly gynecologic examination with ovary ultrasonography no later than 10 years after RT.
Datum přednesení příspěvku: 12. 9. 2008
