Colorectal cancer surveillance in Hodgkin lymphoma survivors at increased risk of therapy-related colorectal cancer: study design

BMC Cancer

Study Protocol

Katarzyna Jóźwiak¹  Flora E. van Leeuwen¹  Manon C. W. Spaander²  Tanya M. Bisseling³  Leon M. Moons⁴  Lisanne S. Rigter⁵  Monique E. van Leerdam⁵  Annemieke Cats⁵  Pieternella J. Lugtenburg⁶  Jan Paul de Boer⁷  John M. M. Raemaekers⁸  Eefke J. Petersen⁹  Petur Snaebjornsson^1,10  Beatriz Carvalho^1,10  Gerrit A. Meijer^1,10  Iris Lansdorp-Vogelaar^1,11  Cecile P. M. Janus^1,12  Berthe M. P. Aleman^1,13  Richard W. M. van der Maazen^1,14  Judith M. Roesink^1,15  Hein te Riele^1,16  Eveline M. A. Bleiker^1,17 

[1] Department of Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands;Department of Gastroenterology and Hepatology, Radboud University Medical Center, Nijmegen, The Netherlands;Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Gastroenterology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands;Department of Hematology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands;Department of Hematology, Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands;Department of Hematology, University Medical Center Utrecht, Utrecht, The Netherlands;Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Public Health, Erasmus MC, University Medical Center, Rotterdam, The Netherlands;Department of Radiation Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands;Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands;Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, The Netherlands;Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands;Division of Biological Stress Response, Netherlands Cancer Institute, Amsterdam, The Netherlands;Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands;

关键词: Hodgkin lymphoma;    Surveillance;    Colonoscopy;    Colorectal neoplasia;    Stool (DNA) test;    Carcinogenesis;   

DOI  :  10.1186/s12885-017-3089-8

 received in 2016-04-05, accepted in 2017-01-20,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSecond primary malignancies are a major cause of excess morbidity and mortality in cancer survivors. Hodgkin lymphoma survivors who were treated with infradiaphragmatic radiotherapy and/or high-dose procarbazine have an increased risk to develop colorectal cancer.Colonoscopy surveillance plays an important role in colorectal cancer prevention by removal of the precursor lesions (adenomas) and early detection of cancer, resulting in improved survival rates. Therefore, Hodgkin lymphoma survivors treated with infradiaphragmatic radiotherapy and/or high-dose procarbazine could benefit from colonoscopy, or other surveillance modalities, which are expected to reduce colorectal cancer incidence and mortality. Current knowledge on clinicopathological and molecular characteristics of therapy-related colorectal cancer is limited. The pathogenesis of such colorectal cancers might be different from the pathogenesis in the general population and therefore these patients might require a different clinical approach.We designed a study with the primary aim to assess the diagnostic yield of a first surveillance colonoscopy among Hodgkin lymphoma survivors at increased risk of colorectal cancer and to compare these results with different screening modalities in the general population. Secondary aims include assessment of the test characteristics of stool tests and evaluation of burden, acceptance and satisfaction of CRC surveillance through two questionnaires.Methods/DesignThis prospective multicenter cohort study will include Hodgkin lymphoma survivors who survived ≥8 years after treatment with infradiaphragmatic radiotherapy and/or procarbazine (planned inclusion of 259 participants). Study procedures will consist of a surveillance colonoscopy with removal of precursor lesions (adenomas) and 6–8 normal colonic tissue biopsies, a fecal immunochemical test and a stool DNA test. All neoplastic lesions encountered will be classified using relevant histomorphological, immunohistochemical and molecular analyses in order to obtain more insight into colorectal carcinogenesis in Hodgkin lymphoma survivors. The Miscan-model will be used for cost-effectiveness analyses.DiscussionEvaluation of the diagnostic performance, patient acceptance and burden of colorectal cancer surveillance is necessary for future implementation of an individualized colorectal cancer surveillance program for Hodgkin lymphoma survivors. In addition, more insight into treatment-induced colorectal carcinogenesis will provide the first step towards prevention and personalized treatment. This information may be extrapolated to other groups of cancer survivors.Trial registrationRegistered at the Dutch Trial Registry (NTR): NTR4961.

【 授权许可】

CC BY   
© The Author(s). 2017