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- W2067372369 abstract "Treatments for Hodgkin lymphoma (HL) have changed substantially over time, with increased emphasis on avoiding long-term treatment-related side effects while maintaining oncologic control. We evaluated changes in treatment strategies in terms of the appearance of second malignancies (SMs) over time. Subjects were 1670 patients treated for HL in January 1956-June 2009 our institution. We evaluated potential relationships between demographics, disease, treatment, recurrence, and occurrence of SMs and death. Two hundred twenty patients (13%) developed SMs (excluding skin cancers). Odds ratios and standardized incidence ratios showed the following factors were associated with higher risk of SM: receipt of cobalt radiation; treatment period (< 1995 vs ≤ 1995); receipt of MOPP chemotherapy; relapse of HL; receipt of ≥3 radiation courses; number and type of radiation fields (particularly mantle radiation in women); and cardiac disease. Risk of death was strongly associated with older age at diagnosis (> 40 years); being treated before 1995; relapse of HL; receipt of 3-field radiation, ≥ 3 radiation courses, and MOPP chemotherapy; and development of SM. Multivariate analyses revealed that factors associated with the development of SM were being treated before 1995 (P < 0.0001), age < 20 years at diagnosis (P = 0.009), receipt of MOPP chemotherapy (P = 0.0004) and ≥ 3 radiation courses (P < 0.001), and cardiac disease (P < 0.0001). The period in which HL was diagnosed and treated was strongly related to the risk of SM; moving away from alkylator-based chemotherapy and decreasing the size of the radiation fields contributed to decreases in the appearance of SMs." @default.
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- W2067372369 date "2014-09-01" @default.
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- W2067372369 title "Improvements in Treatments for Hodgkin Lymphoma Over a 50-Year Period Lead to Fewer Second Malignancies" @default.
- W2067372369 doi "https://doi.org/10.1016/j.ijrobp.2014.05.222" @default.
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