Table 3.
Second Cancers and Cardiac Events, According to Treatment Strategy.
| Event | ABVD Alone (N = 196) | Radiation Therapy, with or without ABVD (N = 203) |
|---|---|---|
| number of patients | ||
| Second cancer* | ||
| Any | 10 | 23† |
| Bladder | 0 | 2 |
| Breast | 1 | 1 |
| Cervix | 0 | 1 |
| Colon | 1 | 0 |
| Leukemia or myelodysplastic syndrome | 0 | 2 |
| Esophagus | 0 | 1 |
| Head and neck | 1 | 0 |
| Lung | 2 | 3 |
| Lymphoma | 3 | 3 |
| Melanoma | 0 | 4 |
| Pancreas | 1 | 0 |
| Prostate | 0 | 1 |
| Rectum | 1 | 2 |
| Sarcoma | 0 | 1 |
| Unknown primary | 0 | 2 |
| Cardiac event | ||
| Any | 16 | 26‡ |
| Death from cardiac causes | 2 | 2 |
| Coronary artery disease | 12 | 15 |
| Myocardial infarction | 6 | 8 |
| Coronary-artery bypass grafting | 3 | 3 |
| Coronary-artery stent insertion | 3 | 2 |
| Angina | 0 | 2 |
| Atrial fibrillation | 1 | 3 |
| Pericarditis or myocarditis | 1 | 3 |
| Valvular disease | 0 | 1 |
| Other | 0 | 2§ |
Basal-cell carcinomas were not included.
A total of 19 second cancers occurred in patients who had an unfavorable risk profile and were assigned to combination therapy (radiation therapy plus ABVD); the 4 second cancers in the cohort with a favorable risk profile (who received radiation therapy only) included lymphoma (2), cervical cancer, and melanoma.
A total of 25 cardiac events occurred in patients who had an unfavorable risk profile and were assigned to combination therapy (radiation therapy plus ABVD); 1 patient in the favorable risk cohort underwent coronary-artery bypass grafting.
Included are one case of peripheral vascular disease requiring bypass grafting and one case of new cardiomegaly.