scholarly journals Gender Disparity in Cardiovascular Mortality following Radiation Therapy for Hodgkin's Lymphoma: A Systematic Review

2020 ◽  
Author(s):  
Yaser Khalid ◽  
Michael Fradley ◽  
Neethi Dasu ◽  
Kirti Dasu ◽  
Ankit Shah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Background Radiation ◽  
Radiation Treatment ◽  
Hodgkin's Lymphoma ◽  
Secondary Outcome ◽  
All Cause Mortality ◽  
Radiation Induced ◽  
Meta Regression

Abstract Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there has been very little investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. PubMed, google scholar, and Cochrane databases were searched to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.

scholarly journals Gender Disparity in Cardiovascular Mortality following Radiation Therapy for Hodgkin's Lymphoma: A Systematic Review

2020 ◽  
Author(s):  
Yaser Khalid ◽  
Michael Fradley ◽  
Neethi Dasu ◽  
Kirti Dasu ◽  
Ankit Shah ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Background Radiation ◽  
Hodgkin's Lymphoma ◽  
Secondary Outcome ◽  
Cochrane Central Register ◽  
All Cause Mortality ◽  
Radiation Induced ◽  
Meta Regression

Abstract Background Radiation-induced coronary artery disease (R-CAD) has become an increasingly recognized phenomenon. Although the clinical relationship between radiation therapy and CAD risk is well known, there is minimal investigation of the gender relationship to radiation-induced CAD events and resulting cardiovascular (CV) mortality. We study the gender variation in the incidence of CV events/mortality related to R-CAD in Hodgkin’s Lymphoma (HL) patients. Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used in this systematic review and network meta-analysis. OVID, Cochrane Central Register of Controlled Trials via the Wiley Interface, Web of Science Core Collection, MEDLINE, EMBASE, and Google Scholar were investigated to identify prospective and retrospective observational studies comparing women and men following radiation treatment for Hodgkin's lymphoma. 10 studies were included (4 prospective, 6 retrospective). The primary outcome was incidence of cardiovascular events and mortality. The secondary outcome was all-cause mortality. Meta-regression for age was also performed. Results Of 13,975 patients including 41% females and 59% males, CV events/mortality was noted to be significantly higher in women compared to men (OR 3.74, 95% CI 2.44-5.72, p <0.001). All-cause mortality was also higher in women compared to men (OR 1.94, 95% CI 1.10-3.44, p <0.023). On meta-regression analysis, elderly populations have a higher rate of mortality which was even higher for women than men (coefficient = 0.0458, p=0.0374). Conclusions Women have a higher rate of CAD related CV events/mortality and all-cause mortality compared to men in radiation treated patients. These data highlight the need for increased surveillance to better monitor for CAD in female patients treated with mantle or mediastinal radiation.

A Systematic Review Evaluating the Addition of Radiation Therapy to Chemotherapy for Localized Aggressive Non-Hodgkin’s Lymphoma: What Is the Role for Radiotherapy?.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3155-3155
Author(s):  
Daniel B. Fried ◽  
David E. Morris ◽  
Thomas C. Shea ◽  
Robert Z. Orlowski ◽  
Hendrik W. Van Deventer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Randomized Trials ◽  
Early Stage ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Hodgkin's Lymphoma ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

Abstract Purpose/Objective: We performed a systematic review and meta-analysis of chemotherapy alone compared to chemotherapy plus radiation in the management of adult early stage aggressive non-Hodgkin’s lymphoma (NHL). Overall survival (OS) and disease-free survival (DFS) at 5 years were evaluated. Materials/Methods: Randomized trials published after 1990 comparing chemotherapy alone to chemotherapy plus radiation therapy in the management of adult aggressive NHL were identified through searches of MEDLINE and CANCERLIT databases. In addition, a search of ASTRO, ASCO, and ASH Proceedings from 1999 to the present was performed to identify updates of published articles and abstracts. Studies that were limited to GI sites only were excluded. Only studies employing CHOP or CHOP-like regimens and radiation therapy to a minimum dose of 30 Gy were deemed acceptable. Chemotherapy alone regimens had to consist of a minimum of 4 cycles of therapy. All trials reported OS and DFS at 5 years. A meta-analysis was performed using STATA statistical software, including tests for homogeneity and publication bias. Trials were analyzed by risk ratio (RR) method. Results: Five randomized trials (n = 1933, range for individual studies 215 to 647) were identified that met all inclusion criteria. The 5-yr OS and DFS RRs for the addition of radiation therapy to chemotherapy are presented in Figures 1 and 2, respectively. Three studies suggested an OS and DFS benefit with the addition of radiation to chemotherapy and two suggested an improved OS and DFS among patients treated with chemotherapy alone. Only two of the studies reported patterns of relapse (Aviles et al and Horning et al). These studies showed improved local control with combined modality therapy (16 – 23% vs. 4 – 5%). Risk ratios for OS ranged from 0.90 to 1.56. DFS estimates range from 0.89 to 1.82. A meta-analysis was conducted to estimate the overall treatment effects for this group of studies for both OS and DFS. Due to the high degree of heterogeneity among these trials (p-value for heterogeneity &lt;0.001 for both OS and DFS), summarizing these results with a pooled estimate of effect would be inappropriate. Heterogeneity was decreased only marginally with the exclusion of any individual study from the pooled estimate. Conclusions: It remains unclear whether early stage aggressive NHL patients benefit from the addition of radiation to CHOP-based chemotherapy. However, at this time we are not able to delineate those patients who will benefit from radiotherapy from those who will not. Currently CHOP-based chemotherapy plus radiation remains a standard of care in the US for early stage aggressive NHL. However, controversy remains regarding the role of radiation in light of conflicting results. Our ability to draw firm conclusions based on this review is limited due to the study heterogeneity. Differences among study populations may largely account for this heterogeneity.

scholarly journals Investigation of Radiation-Induced Toxicity in Head and Neck Cancer Patients through Radiomics and Machine Learning: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Roberta Carbonara ◽  
Pierluigi Bonomo ◽  
Alessia Di Rito ◽  
Vittorio Didonna ◽  
Fabiana Gregucci ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Background Radiation ◽  
Radiation Treatment ◽  
Radiation Induced

Background. Radiation-induced toxicity represents a crucial concern in oncological treatments of patients affected by head and neck neoplasms, due to its impact on survivors’ quality of life. Published reports suggested the potential of radiomics combined with machine learning methods in the prediction and assessment of radiation-induced toxicities, supporting a tailored radiation treatment management. In this paper, we present an update of the current knowledge concerning these modern approaches. Materials and Methods. A systematic review according to PICO-PRISMA methodology was conducted in MEDLINE/PubMed and EMBASE databases until June 2019. Studies assessing the use of radiomics combined with machine learning in predicting radiation-induced toxicity in head and neck cancer patients were specifically included. Four authors (two independently and two in concordance) assessed the methodological quality of the included studies using the Radiomic Quality Score (RQS). The overall score for each analyzed study was obtained by the sum of the single RQS items; the average and standard deviation values of the authors’ RQS were calculated and reported. Results. Eight included papers, presenting data on parotid glands, cochlea, masticatory muscles, and white brain matter, were specifically analyzed in this review. Only one study had an average RQS was ≤ 30% (50%), while 3 studies obtained a RQS almost ≤ 25%. Potential variability in the interpretations of specific RQS items could have influenced the inter-rater agreement in specific cases. Conclusions. Published radiomic studies provide encouraging but still limited and preliminary data that require further validation to improve the decision-making processes in preventing and managing radiation-induced toxicities.

scholarly journals A review on the dosimetrical and radiobiological prediction of radiation-induced hypothyroidism in radiation therapy of head-and-neck cancer, breast cancer, and Hodgkin’s lymphoma survivors

2018 ◽  
Vol 24 (4) ◽  
pp. 137-148
Author(s):  
Aysan Mohammad Namdar ◽  
Mohammad Mohammadzadeh ◽  
Murat Okutan ◽  
Asghar Mesbahi
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Head And Neck ◽  
Hodgkin’S Lymphoma ◽  
Normal Tissue Complication Probability ◽  
Hodgkin's Lymphoma ◽  
Cancer Breast ◽  
Treatment Plans ◽  
Radiation Induced ◽  
Pre Treatment

Abstract A review on the radiobiological modeling of radiation-induced hypothyroidism after radiation therapy of head-and-neck cancers, breast cancer, and Hodgkin’s lymphoma is presented. The current review is based on data relating to dose-volume constrains and normal tissue complication probability (NTCP) as a function of either radiobiological or (pre)treatment-clinical parameters. Also, these data were explored in order to provide more helpful criteria for radiobiological optimization of treatment plans involving thyroid gland as a critical normal organ.

A Systematic Review on Intensity Modulated Radiation Therapy for Mediastinal Hodgkin’s Lymphoma

2021 ◽  
pp. 103437
Author(s):  
Michela Buglione ◽  
Andrea Emanuele Guerini ◽  
Andrea Riccardo Filippi ◽  
Luigi Spiazzi ◽  
Nadia Pasinetti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Hodgkin’S Lymphoma ◽  
Intensity Modulated Radiation Therapy ◽  
Hodgkin's Lymphoma ◽  
Intensity Modulated

SINGLE-FACTOR LINEAR REGRESSION MODEL OF HODGKIN’S LYMPHOMA IN ADOLESCENTS

2017 ◽  
Vol 63 (2) ◽  
pp. 320-325
Author(s):  
Svetlana Kuleva ◽  
Svetlana Ivanova ◽  
Andrey Karitskiy ◽  
Darya Zvyagintseva
Keyword(s):  
Radiation Therapy ◽  
Linear Regression ◽  
Predictive Factors ◽  
Hodgkin’S Lymphoma ◽  
Risk Group ◽  
Hodgkin's Lymphoma ◽  
Regression Equations ◽  
Single Factor ◽  
Number Of Cycles ◽  
Selection Of

With the use of regression and dispersion analyzes conducted in this study it was possible to identify predictive factors that significantly worsen the prognosis of Hodgkin’s lymphoma in adolescents however constructed regression equations did not pass the quality assessment of the models, which did not allow them to be used for the construction of point and interval predictions. In a cohort of patients enrolled in the study a risk-adapted treatment program based on the risk group for stratification was conducted. Negative aspects of the results of our study could be related to the already selected volume of the program for these patients. In turn our analysis proves the validity of the selection of therapeutic loads (a number of cycles of polychemotherapy, doses of radiation therapy) depending on the risk group, into which the adolescent is stratified.

scholarly journals Natural history and treatment options of radiation-induced brain cavernomas: a systematic review

2021 ◽  
Author(s):  
Gildas Patet ◽  
Andrea Bartoli ◽  
Torstein R. Meling
Keyword(s):  
Systematic Review ◽  
Natural History ◽  
Radiation Treatment ◽  
Neurological Deficits ◽  
Cochrane Library ◽  
Average Dose ◽  
Cavernous Malformations ◽  
Radiation Induced ◽  
The Mean

AbstractRadiation-induced cavernous malformations (RICMs) are delayed complications of brain irradiation during childhood. Its natural history is largely unknown and its incidence may be underestimated as RCIMS tend to develop several years following radiation. No clear consensus exists regarding the long-term follow-up or treatment. A systematic review of Embase, Cochrane Library, PubMed, Google Scholar, and Web of Science databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was performed. Based on our inclusion/exclusion criteria, 12 articles were included, totaling 113 children with RICMs, 86 were treated conservatively, and 27 with microsurgery. We were unable to precisely define the incidence and natural history from this data. The mean age at radiation treatment was 7.3 years, with a slight male predominance (54%) and an average dose of 50.0 Gy. The mean time to detection of RICM was 9.2 years after radiation. RICM often developed at distance from the primary lesion, more specifically frontal (35%) and temporal lobe (34%). On average, 2.6 RICMs were discovered per child. Sixty-seven percent were asymptomatic. Twenty-one percent presented signs of hemorrhage. Clinical outcome was favorable in all children except in 2. Follow-up data were lacking in most of the studies. RICM is most often asymptomatic but probably an underestimated complication of cerebral irradiation in the pediatric population. Based on the radiological development of RICMs, many authors suggest a follow-up of at least 15 years. Studies suggest observation for asymptomatic lesions, while surgery is reserved for symptomatic growth, hemorrhage, or focal neurological deficits.

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