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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004694naa a2200517 4500
001oai:DiVA.org:uu-222094
003SwePub
008140408s2002 | |||||||||||000 ||eng|
009oai:prod.swepub.kib.ki.se:18073956
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-2220942 URI
0247 a http://kipublications.ki.se/Default.aspx?queryparsed=id:180739562 URI
0247 a https://doi.org/10.1093/jnci/94.3.1822 DOI
040 a (SwePub)uud (SwePub)ki
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Travis, Lois Bu National Cancer Institute, USA4 aut
2451 0a Lung cancer following chemotherapy and radiotherapy for Hodgkin's disease
264 1b Oxford University Press (OUP),c 2002
338 a print2 rdacarrier
520 a BACKGROUND: Lung cancer is a frequent cause of death in patients cured of Hodgkin's disease, but the contributions of chemotherapy, radiotherapy, and smoking are not well described. We quantified the risk of treatment-associated lung cancer, taking into account tobacco use.METHODS: Within a population-based cohort of 19 046 Hodgkin's disease patients (diagnosed from 1965 through 1994), a case-control study of lung cancer was conducted. The cumulative amount of cytotoxic drugs, the radiation dose to the specific location in the lung where cancer developed, and tobacco use were compared for 222 patients who developed lung cancer and for 444 matched control patients. All statistical tests were two-sided.RESULTS: Treatment with alkylating agents without radiotherapy was associated with increased lung cancer risk (relative risk [RR] = 4.2; 95% confidence interval [CI] = 2.1 to 8.8), as was radiation dose of 5 Gy or more without alkylating agents (RR = 5.9; 95% CI = 2.7 to 13.5). Risk increased with both increasing number of cycles of alkylating agents and increasing radiation dose (P for trend <.001). Among patients treated with mechlorethamine, vincristine, procarbazine, and prednisone (MOPP), risk increased with cumulative amounts of mechlorethamine and procarbazine (P<.001) when evaluated separately. Statistically significantly elevated risks of lung cancer were apparent within 1-4 years after treatment with alkylating agents, whereas excess risk after radiotherapy began 5 years after treatment and persisted for more than 20 years. Risk after treatment with alkylating agents and radiotherapy together was as expected if individual excess risks were summed. Tobacco use increased lung cancer risk more than 20-fold; risks from smoking appeared to multiply risks from treatment.CONCLUSIONS: Past treatments with alkylating agents and radiation therapy for Hodgkin's disease were associated with an increased risk of lung cancer in a dose-dependent and additive fashion. The precise risk estimates, however, should be interpreted cautiously, given the possible residual and enhancing effects of tobacco.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Cancer och onkologi0 (SwePub)302032 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cancer and Oncology0 (SwePub)302032 hsv//eng
7001 a Gospodarowicz, Maryu Canada4 aut
7001 a Curtis, Rochelle Eu National Cancer Institute, USA4 aut
7001 a Clarke, E Aileenu Toronto4 aut
7001 a Andersson, Michaelu Denmark4 aut
7001 a Glimelius, Bengtu Karolinska Institutet,Uppsala universitet,Enheten för onkologi4 aut0 (Swepub:uu)bengglim
7001 a Joensuu, Timou Finland4 aut
7001 a Lynch, Charles Fu Iowa4 aut
7001 a van Leeuwen, Flora Eu The Netherlands4 aut
7001 a Holowaty, Ericu Toronto4 aut
7001 a Storm, Hansu Denmark4 aut
7001 a Glimelius, Ingridu Uppsala universitet,Institutionen för radiologi, onkologi och strålningsvetenskap,Karolinska Institutet4 aut0 (Swepub:uu)inggl846
7001 a Pukkala, Eerou Finland4 aut
7001 a Stovall, Marilynu Houston4 aut
7001 a Fraumeni, Joseph F,c Jru National Cancer Institute, USA4 aut
7001 a Boice, John D,c Jru USA4 aut
7001 a Gilbert, Ethelu National Cancer Institute, USA4 aut
7102 a National Cancer Institute, USAb Canada4 org
7730 t Journal of the National Cancer Instituted : Oxford University Press (OUP)g 94:3, s. 182-192q 94:3<182-192x 0027-8874x 1460-2105
8564 u https://academic.oup.com/jnci/article-pdf/94/3/182/9849288/182.pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-222094
8564 8u http://kipublications.ki.se/Default.aspx?queryparsed=id:18073956
8564 8u https://doi.org/10.1093/jnci/94.3.182

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