Kathryn Lowry MD, Presenter: Nothing to Disclose

Ekin Turan, Abstract Co-Author: Nothing to Disclose

Jonathan David Eisenberg BA, Abstract Co-Author: Nothing to Disclose

Jeffrey Barnes, Abstract Co-Author: Nothing to Disclose

Pari Pandharipande MD, MPH, Abstract Co-Author: Nothing to Disclose

To compare risks of death and life expectancy losses from recurrent lymphoma to those due to radiation exposure from surveillance CT scans in patients with limited-stage Hodgkin’s lymphoma.

We adapted a previously developed Markov model to project lifetime mortality risks and life expectancy losses due to lymphoma versus radiation-induced cancers from surveillance CT in hypothetical patients with limited-stage Hodgkin’s lymphoma. In the base case, we modeled 35-year-old men and women undergoing seven surveillance CT scans of the chest, abdomen, and pelvis over 5 years. Radiation-induced cancer risks and mortality for 17 organ systems were modeled using an organ-specific approach that accounted for specific anatomy exposed at CT. Cohorts of 20-, 50-, and 65-year-old men and women were evaluated in secondary analyses. Markov Chain Monte Carlo methods were used to estimate the uncertainty (95% confidence intervals) of radiation risk projections.

In 35-year-old men and women, respectively, we projected 3,324/100,000 and 3,345/100,000 deaths due to recurrent lymphoma, and 245±126/100,000 and 317±118/100,000 radiation-induced cancer deaths. Discrepancies in projected life expectancy losses from lymphoma (428 days in men, 482 days in women) and radiation-induced cancers (11.6±6.0 days in men, 15.6±5.8 days in women) were proportionately higher, due in part to the delayed timing of deaths from radiation-induced cancers over the cohorts’ lifetimes. Attributable deaths and life expectancy losses from radiation-induced cancers were highest in the youngest cohorts, and discrepancies in life expectancy losses from lymphoma versus radiation-induced cancers were more pronounced at younger ages.

Given the low rate of radiation-induced cancer deaths due to CT surveillance of limited-stage Hodgkin’s lymphoma, modest benefits would justify its use. Life expectancy losses from recurrent lymphoma are substantially higher than those from radiation-induced cancers due in part to the differential timing of these events.

In patients with limited-stage Hodgkin’s lymphoma undergoing CT surveillance, from a health outcomes perspective, modest benefits would justify its use.

Lowry, K, Turan, E, Eisenberg, J, Barnes, J, Pandharipande, P, Projected Effects of Radiation-induced Cancers on Life Expectancy in Patients Undergoing CT Surveillance for Limited-stage Hodgkin’s Lymphoma: A Markov Model.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014919.html