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||Risk of non-hodgkin lymphoma after radiotherapy for primary solid cancers.
||Kim CJ, Freedman DM, Curtis RE, Berrington de Gonzalez A, Morton LM
||Am J Epidemiol
||2011 Jun 1
||Ionizing radiation is an established risk factor for acute leukemia. Recent studies have suggested that radiation may also increase the risk of other hematologic malignancies such as chronic lymphocytic leukemia and possiblynon-Hodgkin lymphoma (NHL). To further investigate high-dose ionizing radiation and NHL risk, we compared second primary NHL incidence among patients who were vs. were not initially treated with radiotherapy for a first primary non-hematologic malignancy during 1982-2006, as reportedin 9 Surveillance, Epidemiology, and End Results population-based cancer registries. We identified 7,242 second NHL cases among 183,843 one-year survivors (11,339,950 total person-years at risk). Risk of NHL was increased for patients treated with radiotherapy for all solid tumors (unadjusted relative risk [RR]:1.12, 95% confidence interval [CI]:1.06-1.18). Similar results were observed after radiotherapy for colon (RR:1.58, 95%CI:1.04-2.41), rectosigmoid junction (RR:1.79, 95% CI:1.14-2.83), lung and bronchus (RR:1.37, 95% CI:1.06-1.77), and thyroid cancers (RR:1.48, 95% CI:1.03-2.14). Risks peaked 5-9 years following radiotherapyand were highest for younger patients (< 60 years). Preliminary analyses suggest higher risks for diffuse large B-cell lymphoma than other NHL subtypes. Additional analyses will use Poisson regression to evaluate radiotherapyrisks adjusted for age, sex, latency, stage, year of diagnosis, and chemotherapy. This study could provide further insights into whether NHL is associated with radiation exposure.