Surgical Therapy and DH-II-90 Protocol in the Treatment of Hodgkin Disease in Young Adults: an Ecological Study
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n3.2200Keywords:
Hodgkin disease/epidemiology, drug therapy, radiotherapy, mortalityAbstract
Introduction: Hodgkin disease (HD) is a pathology that starts in the lymph nodes, develops in the neoplastic tissues and manifests, mainly, in young adults. Objective: To correlate the results of the surgical therapy and the DH- II-90 protocol in young adults affected by HD, and to associate them with the epidemiological profile, the mortality data by the disease and the distribution of physical resources in Brazil. Method: Exploratory ecological study with information collected from the Informatics Department of the National Health System (DATASUS), the National Cancer Institute José Alencar Gomes da Silva (INCA), the National Registry of Health Establishments (CNES) and the SUS Outpatient Information System (SIA/SUS) between 2013 and 2021. The study, therefore, compares the results of surgical therapy and the DH-II-90 protocol associated with epidemiological data, and the protocol is considered the most efficient method, as it produces better results when compared to more invasive methods. Results: The Southeast Region concentrates high number of beds and procedures and stands out due to more expressive numbers of patients diagnosed from 0 to 29 years. In short, crude mortality rates per HD decreased from 1990, the period where the DH-II-90 protocol was applied. Conclusion: This study provides a relevant view on the epidemiological profile of HD and contributes for the comparison between surgical therapy and the DH-II-90 protocol, being possible to conclude that after the application of the protocol, there was a reduction of the mortality rate by HD in Brazil and worldwide.
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References
Swerdlow SH, Campo E, Harris NL, et al., editors.WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. Lyon (France): International Agency for Research on Cancer; 2008.
Connors JM, Cozen W, Steidl C, et al. Hodgkin lymphoma. Nat Rev Dis Primers. 2020;6(1):61. doi: https://doi.org/10.1038/s41572-020-0189-6 DOI: https://doi.org/10.1038/s41572-020-0189-6
Machado M, Correia A, Falcão LM, et al. Linfoma de Hodgkin: conceitos actuais. Medicina Interna [Internet]. 2004 [acesso 2021 nov 5];11(4):207-15. Disponível em: https://www.spmi.pt/revista/vol11/vol11_n4_2004_207-215.pdf
PAINEL-Oncologia [Internet]. Brasília (DF): DATASUS. [data desconhecida] - [atualizado 2022 jul 15; acesso 2021 ago 19]. Disponível em: http://tabnet.datasus.gov.br/cgi/dhdat.exe?PAINEL_ONCO/PAINEL_ONCOLOGIABR.def
National Cancer Institute, Surveillance, Epidemiology, and End Results [Internet]. Bethesda (MD): SEER; [date unknown]. Cancer stat facts: Hodgkin lymphoma; [2018]. [cited 2021 Nov 5]. Available from: https://seer.cancer.gov/statfacts/html/hodg.html
Souza LNS. Doença de Hodgkin: análise do protocolo DH-II-90 [dissertação na Internet]. São Paulo (SP): Universidade de São Paulo, Faculdade de Medicina; 2010. doi: https://doi.org/10.11606/D.5.2010.tde-07052010-162554 DOI: https://doi.org/10.11606/D.5.2010.tde-07052010-162554
Carbone PP, Kaplan HS, Musshoff K, et al. Report of the committee on Hodgkin’s disease staging classification. Cancer Res Internet. 1971 [cited 2021 Aug 12]; 31:1860-1. Available from: https://cancerres.aacrjournals.org/content/canres/31/11/1860.full.pdf DOI: https://doi.org/10.1080/00029238.1971.11080818
Tahir F, Ahmed J, Malik F. Post-splenectomy sepsis: a review of the literature. Cureus. 2020; 12(2):e6898. doi: https://doi.org/10.7759/cureus.6898 DOI: https://doi.org/10.7759/cureus.6898
Donaldson SS, Glatstein E, Vosti KL. Bacterial infections in pediatric Hodgkin's disease: relationship to radiotherapy, chemotherapy and splenectomy. Cancer. 1978;41(5):1949-58. doi: https://doi.org/10.1002/1097-0142(197805)41:5%3C1949::AID-CNCR2820410539%3E3.0.CO;2-K DOI: https://doi.org/10.1002/1097-0142(197805)41:5<1949::AID-CNCR2820410539>3.0.CO;2-K
Hodgson DC, Hudson MM, Constine LS. Pediatric Hodgkin lymphoma: maximizing efficacy and minimizing toxicity. Semin Radiat Oncol. 2007;17(3):230-42 doi: https://doi.org/10.1016/j.semradonc.2007.02.009 DOI: https://doi.org/10.1016/j.semradonc.2007.02.009
Shanbhag S, Ambinder RF. Hodgkin lymphoma: a review and update on recent progress. CA Cancer J Clin. 2017;68(2):116-32. doi: https://doi.org/10.3322/caac.21438 DOI: https://doi.org/10.3322/caac.21438
Lopes GCB, Moreira WB, Soares AN. Avaliação dos resultados do tratamento de pacientes portadores de linfoma de Hodgkin com esquema ABVD em primeira linha. Rev Bras Oncol Clin [Internet]. 2012 [acesso 2021 nov 5];8(29):112-120. Disponível em: https://www.sboc.org.br/app/webroot/Site_RBOC_OFICIAL/pdf_edicao_29/artigo1.pdf
Baiocch O, Penna AMD. Linfoma de Hodgkin, quais as recomendações para diagnóstico e tratamento? Onco News [Internet]. 2019 [acesso 2021 ago 3];1(2). Disponível em: https://www.onconews.com.br/site/revista-index-onconews/todas-edi%C3%A7%C3%B5es-index-onconews/vol-i-n%C3%BAmero-02-jan-2019/4883-linfoma-de-hodgkin,-quais-as-recomenda%C3%A7%C3%B5es-para-diagn%C3%B3stico-e-tratamento.html#:~:text=O%20diagn%C3%B3stico%20de%20linfoma%20de,suficiente%20para%20subclassificar%20a%20doen%C3%A7a
Hudson MM. Pediatric Hodgkin’s therapy: time for a paradigm shift. J Clin Oncol. 2002;20(18):3755-7. doi: https://doi.org/10.1200/JCO.2002.20.18.3755 DOI: https://doi.org/10.1200/JCO.2002.20.18.3755
Bartlett NL. Modern treatment of Hodgkin lymphoma. Curr Opin Hematol. 2008;15(4):408-14. doi: https://doi.org/10.1097/MOH.0b013e328302c9d8 DOI: https://doi.org/10.1097/MOH.0b013e328302c9d8
Eichenauer DA, Aleman BMP, André M, et al. Hodgkin lymphoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):iv19-iv29. doi: https://doi.org/10.1093/annonc/mdy080 DOI: https://doi.org/10.1093/annonc/mdy080
Atlas On-line de Mortalidade [Internet]. Rio de Janeiro: Instituto Nacional de Câncer José Alencar Gomes da Silva. c1996-2014 - [acesso 2021 ago 2]. Disponível em: https://mortalidade.inca.gov.br/MortalidadeWeb
CNES: Cadastro Nacional de Estabelecimentos de Saúde [Internet]. Brasília, DF: DATASUS. [2000] – [acesso 2021 nov 10]. Disponível em: http://cnes.datasus.gov.br/
SIA/SUS: Sistema de Informação Ambulatorial [Internet]. Brasília, DF: DATASUS. [data desconhecida] – [acesso 2021 nov 10]. Disponível em: http://sia.datasus.gov.br/principal/index.php
Instituto Brasileiro de Geografia e Estatística [Internet]. Rio de Janeiro: IBGE; [data desconhecida]. PNAD - Pesquisa Nacional por Amostra de Domicílios; 2015 [acesso 2021 nov 6]. Disponível em: https://www.ibge.gov.br/estatisticas/sociais/populacao/9127-pesquisa-nacional-por-amostra-de-domicilios.html?=&t=resultados
Spector N. Abordagem atual dos pacientes com doença de Hodgkin. Rev Bras Hematol Hemoter. 2004;26(1):35-42. doi: https://doi.org/10.1590/S1516-84842004000100007 DOI: https://doi.org/10.1590/S1516-84842004000100007
Noordijk EM, Carde P, Dupouy N, et al. Combined-modality therapy for clinical stage I or II Hodgkin’s lymphoma: long-term results of the European Organisation for Research and Treatment of Cancer H7 randomized controlled trials. J Clin Oncol. 2006;24(19):3128-35. doi: https://doi.org/10.1200/JCO.2005.05.2746 DOI: https://doi.org/10.1200/JCO.2005.05.2746
Souza LNS, Junior PTM, Almeida MTA, et al. Linfoma de Hodgkin na infância e adolescência: 15 anos de experiência com o protocolo DH-II-90. Rev Bras Hematol Hemoter. 2010;32(4):295-302. doi: https://doi.org/10.1590/S1516-84842010005000085 DOI: https://doi.org/10.1590/S1516-84842010005000085
Gómez-Almaguer D, González-Llano O, Jiménez-Antolinez V, et al. Treatment of classical Hodgkin’s lymphoma in children and adolescents. Expert Opin Pharmacother. 2019;20(10):1227-34. doi: https://doi.org/10.1080/14656566.2019.1606212 DOI: https://doi.org/10.1080/14656566.2019.1606212
Villa D, Sehn LH, Aquino-Parsons C, et al. Interim PET-directed therapy in limited-stage Hodgkin lymphoma initially treated with ABVD. Haematologica. 2018;103(12):e590-3. doi: https://doi.org/10.3324/haematol.2018.196782 DOI: https://doi.org/10.3324/haematol.2018.196782
Straus DJ, Jung SH, Pitcher B, et al. CALGB 50604: risk-adapted treatment of nonbulky early-stage Hodgkin lymphoma based on interim PET. Blood. 2018;132(10):1013-21. doi: https://doi.org/10.1182/blood-2018-01-827246 DOI: https://doi.org/10.1182/blood-2018-01-827246
Schellong G. Pediatric Hodgkin's disease: treatment in the late 1990s. Ann Oncol. 1998;9(Suppl 5):S115-9. doi: https://doi.org/10.1093/annonc/9.suppl_5.S115 DOI: https://doi.org/10.1093/annonc/9.suppl_5.S115
Connors JM, Jurczak W, Straus DJ, et al. Brentuximab vedotin with chemotherapy for stage III or IV Hodgkin’s lymphoma. N Engl J Med. 2018;378(4):331-44. doi: https://doi.org/10.1056/NEJMoa1708984 DOI: https://doi.org/10.1056/NEJMoa1708984
Younes A, Gopal AK, Smith SE, Ansell SM, et al. Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin’s lymphoma. J Clin Oncol. 2012;30(18):2183-9. doi: https://doi.org/10.1200/JCO.2011.38.0410 DOI: https://doi.org/10.1200/JCO.2011.38.0410
Guru Murthy GS, Szabo A, Hamadani M, et al. Contemporary outcomes for advanced-stage classical Hodgkin lymphoma in the U.S.: analysis of surveillance, epidemiology, and end results database. Oncologist. 2019;24(11):1488-95. doi: https://doi.org/10.1634/theoncologist.2019-0172 DOI: https://doi.org/10.1634/theoncologist.2019-0172
Engert A, Haverkamp H, Kobe C, et al. Reduced-intensity chemotherapy and PET-guided radiotherapy in patients with advanced stage Hodgkin’s lymphoma (HD15 trial): a randomised, open-label, phase 3 non-inferiority trial. Lancet. 2012;379(9828):1791-9. doi: https://doi.org/10.1016/S0140-6736(11)61940-5 DOI: https://doi.org/10.1016/S0140-6736(11)61940-5
Canellos GP, Rosenberg SA, Friedberg JW, et al. Treatment of Hodgkin lymphoma: a 50-year perspective. J Clin Oncol. 2014;32(3):163-8. doi: https://doi.org/10.1200/JCO.2013.53.1194 DOI: https://doi.org/10.1200/JCO.2013.53.1194
Hoppe RT, Advani RH, Ai WZ, et al. Hodgkin lymphoma, Version 2.2012 featured updates to the NCCN guidelines. J Natl Compr Canc Netw. 2012;10(5):589-97. doi: https://doi.org/10.6004/jnccn.2012.0061 DOI: https://doi.org/10.6004/jnccn.2012.0061
Specht L, Yahalom J, Illidge T, et al. Modern radiation therapy for Hodgkin lymphoma: field and dose guidelines from the International Lymphoma Radiation Oncology Group (ILROG). Int J Radiat Oncol Biol Phys. 2014;89(4):854-62. doi: https://doi.org/10.1016/j.ijrobp.2013.05.005 DOI: https://doi.org/10.1016/j.ijrobp.2013.05.005
Radford J, Illidge T, Counsell N, et al. Results of a trial of PET-directed therapy for early-stage Hodgkin’s lymphoma. N Engl J Med. 2015;372(17):1598-607. doi: https://doi.org/10.1056/NEJMoa1408648 DOI: https://doi.org/10.1056/NEJMoa1408648
Gabriel FA. Estudo da viabilidade econômica e social da implantação de serviços de radioterapia [trabalho de conclusão de curso na Internet]. São Paulo (SP): Universidade Estadual Paulista Júlio de Mesquita Filho, Instituto de Biociências de Botucatu; 2016 [acesso 2021 nov 6]. Disponível em: http://hdl.handle.net/11449/203842
Hixson L, Hepler BB, Kim MO. The white population: 2010 [Internet]. United States: Census Bureau; 2011 Sept [cited 2021 Nov 6]. Available from: https://www.census.gov/content/dam/Census/library/publications/2011/dec/c2010br-05.pdf
Lima CRA, Schramm JMA, Coeli CM, et al. Revisão das dimensões de qualidade dos dados e métodos aplicados na avaliação dos sistemas de informação em saúde. Cad Saúde Pública. 2009;25(10):2095-109. doi: https://doi.org/10.1590/S0102-311X2009001000002 DOI: https://doi.org/10.1590/S0102-311X2009001000002
Jorge M, Laurenti R, Gotlieb, S. Avaliação dos sistemas de informação em saúde no Brasil. Cad Saúde Colet. 2010;18(1):7-18.
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