Lung Cancer and Hodgkin's

Specifics on Lung Cancer and Hodgkin's Disease

For this study, the researchers looked at many different factors, but focused on three main measures:
  • The type and cumulative amount of chemotherapy drugs
  • The radiation dose
  • Tobacco use.
All three exposures contributed significantly to elevated lung cancer risks. Tobacco use, chemotherapy, and radiotherapy doses of five Gray (Gy) or more were reported in 96 percent, 63 percent, and 53 percent of case subjects (those who developed lung cancer), respectively, and in 70 percent, 52 percent, and 41 percent of patients who did not develop lung cancer.
Subjects who received either radiotherapy alone or chemotherapy with drugs called alkylating agents experienced a significantly increased risk of lung cancer. Also, when researchers looked at the group of patients who received both alkylating agents and radiotherapy, the numbers showed risks that were additive.
Researchers also demonstrated that lung cancer risk increased with increasing total amounts of either alkylating agents or radiotherapy dose.
Researchers also wanted to quantify the role of smoking and tobacco use in the development of lung cancer in this group. Of the lung cancers that were diagnosed, researchers estimated that approximately 10 percent were due to treatment alone, 63 percent were due to treatment and smoking combination, 24 percent were due to smoking alone, and 3 percent were cases in which neither smoking nor therapy played a role.
In contrast to the effect of combined treatment, which showed that risks were additive with combined therapy, smoking appeared to multiply the risk of lung cancer. The largest risks for lung cancer were seen in individuals who were heavy smokers and received both radiotherapy and alkylating agents.
The study also provides new information regarding the time of development of lung cancer following treatment for Hodgkin's disease. Researchers found that excess lung cancers diagnosed after chemotherapy treatment with alkylating agents occurred as early as one to four years after the first treatment. In contrast, increases in lung cancers diagnosed after radiotherapy were first noted five years after treatment and persisted for over 20 years.
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