Doxorubicin Exposure and Breast Cancer Risk in Survivors of Adolescent and Adult Hodgkin Lymphoma.
| Autor: | Neppelenbroek SIM; Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Geurts YM; Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Aleman BMP; Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Lugtenburg PJ; Department of Hematology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands., Rademakers SE; Department of Radiation Oncology, Leiden University Medical Center, Leiden, the Netherlands., de Weijer RJ; Department of Hematology, University Medical Center Utrecht, Utrecht, the Netherlands., Schippers MGA; Department of Radiation Oncology, Instituut Verbeeten, Tilburg, the Netherlands., Ta BDP; Department of Radiation Oncology (Maastro), GROW School for Oncology, Maastricht University Medical Centre+, Maastricht, the Netherlands., Plattel WJ; Department of Hematology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Zijlstra JM; Department of Hematology, Amsterdam UMC, Location Vrije Universiteit, Cancer Center Amsterdam, Amsterdam, the Netherlands., van der Maazen RWM; Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands., Nijziel MR; Catharina Cancer Institute, Department of Hemato-Oncology, Catharina Hospital, Eindhoven, the Netherlands., Ong F; Department of Radiotherapy, Medisch Spectrum Twente, Enschede, the Netherlands., Schimmel EC; Department of Radiotherapy, Radiotherapiegroep, Arnhem, the Netherlands., Posthuma EFM; Department of Internal Medicine, Reinier de Graaf Hospital, Delft, the Netherlands., Kersten MJ; Department of Hematology, Amsterdam University Medical Centers, Location University of Amsterdam, Cancer Center Amsterdam, Amsterdam, the Netherlands., Böhmer LH; Department of Hematology, Haga Teaching Hospital, Den Haag, the Netherlands., Muller K; Department of Radiotherapy, Radiotherapiegroep, Deventer, the Netherlands., Koene HR; Department of Hematology, St Antonius Hospital, Nieuwegein, the Netherlands., Te Boome LCJ; Department of Hematology, Haaglanden Medical Center, Den Haag, the Netherlands., Bilgin YM; Department of Internal Medicine, Admiraal De Ruyter Hospital, Goes, the Netherlands., de Jongh E; Department of Internal Medicine, Albert Schweitzer Hospital, Dordrecht, the Netherlands., Janus CPM; Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands., van Leeuwen FE; Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands., Schaapveld M; Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, the Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology [J Clin Oncol] 2024 Jun 01; Vol. 42 (16), pp. 1903-1913. Date of Electronic Publication: 2024 Feb 15. |
| DOI: | 10.1200/JCO.23.01386 |
| Abstrakt: | Purpose: Female Hodgkin lymphoma (HL) survivors treated with chest radiotherapy (RT) at a young age have a strongly increased risk of breast cancer (BC). Studies in childhood cancer survivors have shown that doxorubicin exposure may also increase BC risk. Although doxorubicin is the cornerstone of HL chemotherapy, the association between doxorubicin and BC risk has not been examined in HL survivors treated at adult ages. Methods: We assessed BC risk in a cohort of 1,964 female 5-year HL survivors, treated at age 15-50 years in 20 Dutch hospitals between 1975 and 2008. We calculated standardized incidence ratios, absolute excess risks, and cumulative incidences. Doxorubicin exposure was analyzed using multivariable Cox regression analyses. Results: After a median follow-up of 21.6 years (IQR, 15.8-27.1 years), 252 women had developed invasive BC or ductal carcinoma in situ. The 30-year cumulative incidence was 20.8% (95% CI, 18.2 to 23.4). Survivors treated with a cumulative doxorubicin dose of >200 mg/m 2 had a 1.5-fold increased BC risk (95% CI, 1.08 to 2.1), compared with survivors not treated with doxorubicin. BC risk increased 1.18-fold (95% CI, 1.05 to 1.32) per additional 100 mg/m 2 doxorubicin ( P Conclusion: This study shows that treatment with doxorubicin is associated with increased BC risk in both adolescent and adult HL survivors. Our results have implications for BC surveillance guidelines for HL survivors and treatment strategies for patients with newly diagnosed HL. |
| Databáze: | MEDLINE |
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