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Changes in the use of radiation therapy for early classical Hodgkin lymphoma in adolescents and young adults: implications for survival and second malignancies.
[hodgkin lymphoma, classical]
ABSTRACT
Omission
of
radiation
therapy
(
RT
)
in
adolescents
and
young
adults
(
AYA
)
with
early
classical
Hodgkin
lymphoma
(
cHL
)
may
affect
survival
and
risk
of
second
malignancies
(
SMN
)
.
Using
the
Surveillance
Epidemiology
and
End
Results
database
we
found
reduction
in
RT
use
from
60
.
8
%
among
the
2
,
614
cases
from
1995
-
2002
to
52
.
9
%
among
the
2
,
514
cases
from
2003
-
2010
,
P
<
0
.
001
.
Survival
at
5
-
years
with
and
without
RT
was
95
.
1
%
vs
.
93
.
3
%
,
P
=
0
.
013
for
1995
-
2002
and
97
.
7
%
vs
.
96
.
4
%
,
P
=
0
.
021
for
2003
-
2010
.
Omission
of
RT
was
affected
by
2003
-
2010
era
,
race-ethnicity
,
income
and
education
and
independently
increased
the
risk
of
death
(
HR
1
.
34
,
P
=
0
.
011
)
.
The
cumulative
risk
of
SMN
at
150
months
was
3
.
3
%
vs
.
3
.
0
%
(
P
=
0
.
87
)
while
the
risk
of
death
without
SMN
(
competing
risk
)
was
5
.
7
%
vs
.
8
.
8
%
for
RT
and
no
-
RT
patients
respectively
(
P
=
0
.
0009
)
.
Omission
of
RT
for
early
cHL
in
AYA
may
increase
mortality
without
reduction
in
SMN
.
