Faculty Collaboration Database

ACR Appropriateness Criteria: follow-up of Hodgkin's lymphoma. Curr Probl Cancer 2010;34(3):211-27

Date

06/15/2010

Pubmed ID

20541059

DOI

10.1016/j.currproblcancer.2010.04.007

Scopus ID

2-s2.0-77953100953 (requires institutional sign-in at Scopus site)   32 Citations

Abstract

In the follow-up of Hodgkin's lymphoma patients, the focus in the first 5 years is to detect recurrence, while after 5 years, the focus is on limiting and detecting late effects of treatment. In the first 5 years post-treatment, routine history and physical and computed tomography (CT) imaging (more frequent in the first 2 years) are generally appropriate. However, there are limited data to support the role of positron emission tomography scanning as routine follow-up. Beyond 5 years post-treatment, annual history and physical is appropriate, although there is no longer a role for routine imaging for recurrences. Women irradiated to the chest area at a young age (<35) would benefit from annual mammogram screening given the increased breast cancer risk. Magnetic resonance imaging can be considered, although there is a lack of data supporting its role in this population. Low-dose chest CT for lung cancer screening in patients with history of mediastinal irradiation and/or alkylating chemotherapy exposures and a smoking history can be considered, although data on its utility is lacking. Cardiac screening with echocardiogram and exercise tolerance tests in patients with history of mediastinal irradiation and/or adriamycin exposure may be appropriate, although the optimal screening interval would depend on mediastinal dose, adriamycin dose, presence of other cardiac risk factors and findings at the baseline screening. Patients at risk for cardiac disease due to treatment exposure would also benefit from lipid screening every 1-3 years.

Author List

Ng A, Constine LS, Advani R, Das P, Flowers C, Friedberg J, Hodgson DC, Schwartz CL, Wilder RB, Wilson LD, Yunes MJ

Author

Cindy L. Schwartz MD, MPH Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Combined Modality Therapy
Diagnostic Imaging
Female
Follow-Up Studies
Guideline Adherence
Hodgkin Disease
Humans
Male
Neoplasm Recurrence, Local
Neoplasms, Second Primary
Practice Guidelines as Topic
Survival Rate