Re: Late Effects From Radiation Therapy: The Hits Just Keep on Coming

• Published in: JNCI : Journal of the National Cancer Institute 2010-04, Vol.102 (8), p.576-577
• Main Authors: Aleman, Berthe M. P., de Bruin, Marie L., Dorresteijn, Lucille D. A., Krol, Augustinus D. G., van ‘t Veer, Mars B., Boogerd, Willem, van Leeuwen, Flora E.
• Format: Article
• Language: English
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Dose-Response Relationship, Radiation; Editorials; Heart - radiation effects; Hodgkin Disease - drug therapy; Hodgkin Disease - radiotherapy; Humans; Ischemia; Ischemic Attack, Transient - epidemiology; Ischemic Attack, Transient - etiology; Lymphoma; Meta-analysis; Radiation Injuries - complications; Radiation Injuries - epidemiology; Radiation Injuries - etiology; Radiation Injuries - prevention & control; Radiotherapy - adverse effects; Radiotherapy Dosage; Risk Assessment; Risk Factors; Stroke; Stroke - epidemiology; Stroke - etiology
• ISSN: 0027-8874; 1460-2105
• DOI: 10.1093/jnci/djq069

Aleman et al remark on Longo's recent editorial regarding their article on the increased risk of stroke and transient ischemic attack following Hodgkin lymphoma. Longo criticized the use of radiotherapy in the treatment of Hodgkin lymphoma and stated that chemotherapy is as effective as combined modality treatment and proven to be safe. They argue that Longo overestimated the efficacy of chemotherapy alone in the treatment of Hodgkin lymphoma while at the same time underestimating the toxicity of this treatment. On the other hand, Longo expresses that as a practical matter, even if one grants the unproven assertion that combined modality therapy is more effective than chemotherapy alone in early-stage Hodgkin's disease, it's clear from the meta analysis that the margin is 10% or less.