Louisiana State University Health Sciences Center, Shreveport, LA
Samip R. Master , Nebu V. Koshy , J. Ben Wilkinson , Glenn Morris Mills , Runhua Shi
Background: Hodgkin’s Lymphoma (HL) is curable in up to 80% of patients due, in part, to simultaneous advances in chemotherapy regimens as well as radiation therapy planning and delivery. Concerns regarding the historical use of large-field radiotherapy on overall survival have been published. We performed a SEER data analysis to evaluate the impact of patient and treatment related factors on survival in HL. Methods: Data from 39,700 patients ( ≥ 18 years of age) registered in the SEER with HL diagnosis between 1983-2011 and follow up through 2012 were analyzed. Impact of patient demographics (sex, age, race, and ethnicity, year of diagnosis, family income, education, unemployment, poverty level and stage of disease) and treatment characteristics (delivery of radiotherapy) on survival were evaluated via Multivariate analysis. Results: Median age was 36 years old. Most patients were Ann Arbor Stage II (39%) at diagnosis with the remainder distributed evenly between the remaining stages (I, III, IV: 19-21%). In multivariate analysis, after adjusting for secondary predictor variables including stage of disease, radiation therapy was a statistically significant predictor of overall survival from HL (HR: 0.72, (95% CI: 0.68-0.75). A Kaplan-Meier analysis showed that radiotherapy improved survival for all patients, irrespective of stage. Factors associated with worse survival included older age, male sex, extra nodal disease, advanced stage disease, poverty, African–American race, and Hispanic ethnicity. Conclusions: Radiation therapy improved survival in patients with all stages of HL. Socioeconomic factors associated with worse survival in this study may be related to particular patterns of care and warrant additional study.
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