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Therapy-induced neoplasms
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Ionizing radiation is an established lung carcinogen,29 while the effect of chemotherapy for HL is more controversial.30–32 Boice recently summarized evidence for the carcinogenic influence of lower-linear energy transfer irradiation of the lung.21 A number of case–control studies to date have sought to clarify the relative importance of chemotherapy and radiotherapy for HL in the subsequent occurrence of lung cancer, but results have been inconsistent, based on sparse numbers, and some were inadequately adjusted for tobacco use.30,31 Based on 30 cases, Van Leeuwen et al. found a significant dose–response relation between radiation for HL and lung cancer risk.32 However, radiation dose was averaged across entire lung lobes, with only six cases given mean doses of 9 Gy or more. In larger studies30,31 a quantitative relation between radiation dose and lung cancer risk was not observed. An association between total number of cycles of chemotherapy for HL and lung cancer risk was not evident in one investigation of 98 cases,30 nor with chemotherapy in the Netherlands series.32 Swerdlow et al. noted a relative risk of 1.66 for lung cancer among 45 British HL patients given mechlorethamine, procarbazine, vincristine and prednisone (MOPP); a difference in lung cancer risk after 1–6 compared with 7 or more cycles, however, was not apparent, and data on cumulative dose were not collected.31 Of most analytical investigations only the Dutch study had detailed data on smoking habits.32 Information on tobacco use was gathered for 39 per cent of subjects in the British series,31 and for 59 per cent of patients in the investigation by Kaldor et al.30
Overview of biological mechanisms of human carcinogens
Published in Journal of Toxicology and Environmental Health, Part B, 2019
Nicholas Birkett, Mustafa Al-Zoughool, Michael Bird, Robert A. Baan, Jan Zielinski, Daniel Krewski
MOPP refers to a four-drug chemotherapeutic regimen composed of: mechlorethamine, oncovin, procarbazine, and prednisone. The individual agents were subjected to separate IARC reviews. MOPP was superseded by more recent therapeutic alternatives. MOPP initiates cancer of the lung and acute myeloid leukemia.