Para-aortic radiation correlates with increased diabetes mellitus (DM) risk for Hodgkin’s lymphoma (HL) survivors, according to a study published in the Journal of Clinical Oncology.
Frederika A. van Nimwegen, from the Netherlands Cancer Institute in Amsterdam, and colleagues examined the correlation between treatment for HL and DM risk in a cohort of 2,264 five-year HL survivors. Participants were diagnosed before age 51 years and received treatment between 1965 and 1995. Medical records and general practitioners provided treatment and follow-up information.
The researchers found that 157 patients developed DM after a median follow-up of 21.5 years. After 30 years, the overall cumulative incidence of DM was 8.3 percent. The cumulative incidence of DM was 14.2 percent after para-aortic radiation with ≥36 Gy.
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The risk of DM was increased 2.30-fold with irradiation with ≥36 Gy to the para-aortic lymph nodes and spleen, while the risk was increased 1.82-fold with para-aortic radiation alone with ≥36 Gy. The risk of DM was not significantly increased with lower doses (10 to 35 Gy). Higher mean radiation doses to the pancreatic tail correlated with significantly increased risk of DM (P < 0.001).
“Screening for DM should be considered in follow-up guidelines for HL survivors, and treating physicians should be alert to this increased risk,” the authors write.