{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T04:46:57Z","timestamp":1768711617793,"version":"3.49.0"},"reference-count":40,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2007,10,16]],"date-time":"2007-10-16T00:00:00Z","timestamp":1192492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2007,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND.<\/jats:title><jats:p>Estimates of radiation\u2010related second cancer risk among Hodgkin lymphoma survivors are largely based on radiation therapy (RT) fields and doses no longer in use, and these estimates do not account for differences in normal tissue dose among individual patients. This study gives individualized estimates for the risks of lung and female breast cancer expected with contemporary involved\u2010field RT and low\u2010dose (20 Gy) RT for mediastinal Hodgkin lymphoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS.<\/jats:title><jats:p>Three RT plans were constructed for 37 consecutive patients with mediastinal Hodgkin lymphoma: 35 Gy mantle RT, 35 Gy involved\u2010field RT (IFRT), and 20 Gy IFRT. For each of the 111 RT plans, individual\u2010level dosimetry data were incorporated into a cell initiation\/inactivation\/proliferation model to estimate the excess relative risk (ERR) and cumulative incidence of radiation\u2010induced second cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS.<\/jats:title><jats:p>ERR estimates were compatible with results of epidemiological studies. Compared with 35 Gy mantle radiation therapy, 35 Gy IFRT was predicted to reduce the 20\u2010year ERRs of breast and lung cancer by 63% and 21%, respectively, primarily because of lower normal tissue doses with the omission of axillary RT. Low\u2010dose (20 Gy) IFRT was associated with a 77% and 57% decrease in these ERRs. Patient\u2010specific differences in normal tissue dose with IFRT led to 11\u2010fold and 3.6\u2010fold variations among individual's estimates of breast and lung cancer ERR, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS.<\/jats:title><jats:p>Contemporary IFRT is predicted to substantially reduce risk of secondary breast and lung cancer compared with mantle RT, with considerable variation in risk among individuals. Individualized prospective risk estimates could facilitate patient\u2010specific counseling and the development of more effective RT techniques. Cancer 2007. \u00a9 2007 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.23081","type":"journal-article","created":{"date-parts":[[2007,10,16]],"date-time":"2007-10-16T12:16:24Z","timestamp":1192536984000},"page":"2576-2586","source":"Crossref","is-referenced-by-count":121,"title":["Individualized estimates of second cancer risks after contemporary radiation therapy for Hodgkin lymphoma"],"prefix":"10.1002","volume":"110","author":[{"given":"David C.","family":"Hodgson","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eng\u2010Siew","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tu Huan","family":"Tran","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mostafa","family":"Heydarian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Tsang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melania","family":"Pintilie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tony","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer K.","family":"Sachs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Brenner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,10,16]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.07.131"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-04-1535"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1667\/0033-7587(2003)159[0161:LCATFH]2.0.CO;2"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-2-200207160-00014"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2000.18.3.498"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.11.059"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.09.038"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.0936"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1994.12.2.312"},{"key":"e_1_2_5_11_2","doi-asserted-by":"crossref","first-page":"2673","DOI":"10.1182\/blood.V106.11.2673.2673","article-title":"Combined modality treatment of two or four cycles of ABVD followed by involved field radiotherapy in the treatment of patients with early stage Hodgkin's lymphoma: update interim analysis of the Randomised HD10 Study of the German Hodgkin Study Group (GHSG)","volume":"106","author":"Engert A","year":"2005","journal-title":"Blood."},{"key":"e_1_2_5_12_2","doi-asserted-by":"crossref","first-page":"814","DOI":"10.1182\/blood.V106.11.814.814","article-title":"Comparison of three radiation dose levels after EBVP regimen in favorable supradiaphragmatic clinical stages (CS) I\u2010II Hodgkin's lymphoma (HL): preliminary results of the EORTC\u2010GELA H9\u2010F Trial","volume":"106","author":"Eghbali E","year":"2005","journal-title":"Blood."},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1673.2000.00847.x"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/1748-717X-2-13"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/0360-3016(91)90296-G"},{"key":"e_1_2_5_16_2","first-page":"8","volume-title":"A Symposium Considering Radiation Effects in the Cell and Possible Implications for Cancer Therapy: a Collection of Papers. 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