MIAMI BEACH--Patients treated for Hodgkin's disease are at moderately increased risk of developing secondary gastrointestinal (GI) cancer, Sandra H. Birdwell, MD, said at the American Society for Therapeutic Radiology and Oncol-ogy (ASTRO) meeting.
Dr. Birdwell and her colleagues at Stanford University School of Medicine, where she is a resident in radiation oncol-ogy, identified cases of GI cancer from the records of 2,441 patients treated for Hodgkin's disease between 1961 and 1994. Patients were followed for a mean of 11 years after treatment ended.
The study was undertaken because of concern about the increased rate of subsequent illness in Hodgkin's survivors. "While roughly 85% of Hodgkin's patients can be expected to be cured of this neoplasm, survivors are at increased risk of developing several health problems as a result of Hodgkin's disease or its treatment," Dr. Birdwell said.
In fact, the development of other cancers has been the major factor contributing to excess mortality in this population, she said. An increased risk of breast cancer, lung cancer, and leukemia has been shown in previous studies, but no study had focused exclusively on the incidence of subsequent GI cancer in Hodgkin's survivors.
Overall, 25 patients in the Stanford series were found to have developed invasive GI cancer, Dr. Birdwell said, indicating that Hodgkin's patients were 2.5 times as likely to develop GI cancer as persons without Hodgkin's disease.
The risk of a second cancer was significantly increased for cancers of the stomach, small intestine, and pancreas. By contrast, there was no appreciable increase in the risk of a subsequent cancer in the esophagus or colorectum.
The data also showed that exposure to combined modality therapy resulted in a significant increase in GI cancer risk, while no increased risk was observed after treatment with radiotherapy alone or chemotherapy alone. However, few patients in this series received chemotherapy alone.