Hodgkin's Survivors Who Received Radiation to Pancreas At Risk for Diabetes

Patients treated for Hodgkin's lymphoma in the past who received radiation to the para-aortic (POA) lymph nodes and spleen are at a greater risk of developing diabetes, according to a new study.

The good news is that such radiotherapy is not common today. However, it was not uncommon in the past.

"Although radiotherapy to the spleen is rarely administered nowadays, there are many long-term Hodgkin lymphoma survivors who have received splenic or PAO irradiation as part of Hodgkin lymphoma treatment in the past," writes Frederika A. van Nimwegen, MSc, of the Netherlands Cancer Institute, and colleagues. "In addition, current patients with Hodgkin lymphoma with (residual) upper abdominal disease as well as patients with testicular cancer or stomach cancer may still be exposed to radiation to the pancreas. Treating physicians should be aware of the increased risk of diabetes mellitus among Hodgkin lymphoma survivors treated with PAO radiotherapy."

Van Nimwegen and colleagues looked at 2,264 5-year Hodgkin lymphoma survivors diagnosed before the age of 51 who received radiation of the pancreas.

After a median follow-up of 21.5 years, 157 patients had developed diabetes. Seventeen percent of them received PAO radiotherapy without irradiation to the spleen, and about 30 percent had received PAO radiation with irradiation to the spleen.

The overall incidence of diabetes among the study group was 4.1 percent at 20 years and 8.3 percent at 30 years.

"Our study shows that radiation to the PAO lymph nodes, leading to radiation exposure of the pancreas, is associated with a dose-dependent increased risk of diabetes mellitus in long-term survivors of Hodgkin lymphoma," the researchers wrote in the Journal of Clinical Oncology. "On the basis of current and previous findings, diabetes mellitus screening should be considered in Hodgkin lymphoma follow-up guidelines for patients treated with abdominal radiotherapy."

Source: Cancer Network