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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
.
Diseases
Validation
Diseases presenting
"hodgkin lymphoma"
symptom
esophageal adenocarcinoma
hodgkin lymphoma, classical
monosomy 21
primary effusion lymphoma
severe combined immunodeficiency
systemic capillary leak syndrome
waldenström macroglobulinemia
This symptom has already been validated