[Secondary tumors in Hodgkin's disease patients]

A study is presented of second malignancies detected after treatment for Hodgkin's disease in 942 patients treated at the Institute's Clinic (1973-1993). Solid tumors were diagnosed, generally, during long complete remission, both after chemoradiation or radiotherapy (2.2 and 1.3%, respectively, p > 0.1). Yet, second tumor incidence tended to increase after combination treatment. Intestinal tumors were the most frequent. Tumors did not arise necessarily at sites which had been irradiated. Total doses absorbed by involved organs varied from 4-7 to 24-44 Gy, thus implying that absolute values of such doses did not correlate directly with risk of solid tumor development; the same was true for size of exposure fields. Dose distribution in time is of particular interest: there were no tumors among those treated with accelerated multifractionated irradiation. If radiotherapy procedures are improved and individual schedules of fractionated irradiation are used, the probability of solid tumor incidence, which, after radiotherapy of Hodgkin's disease, is not very high, can be still lowered.