| Paper # 001 | Versión
en Español |
Marcial Garcia-Rojo, Jesús González, Ana Morillo, Jesús Martín
[Title] [Materials and Methods] [Results] [Discussion] [Pictures] [Bibliography]
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The more aggressive treatment with chemotherapy agents and radiotherapy in cancer patients has favored longer survivals, but also has raised the concern about the possibility of inducing seconds neoplasms in these patients.
It is well known that patients with some kind of cancer like endometrial or ovarian carcinomas are at a higher risk of developing a second neoplasms like breast carcinoma than the general population (1,2). This higher risk may be accentuated by some forms of therapy. For instance, in the case of a lymphoma, a higher incidence of up to 5% of a acute myelogenous leukemia has been described after combined radiotherapy and chemotherapy treatment (3,4).
Hodgkin’s lymphoma patients are know to have a greater incidence of second malignancies like leukemias, sarcomas and tumors of the central nervous system (3,4,5,6), but carcinomas are not so frequent (4,5,7,8). In non Hodgkin lymphomas the association of seconds tumor, simultaneous or metachronous, is not so common (9,10). Most of these second neoplasms in non Hodgkin lymphomas are carcinomas of the prostate, kidney or colon (11).
Although the association of a stomach lymphoma and a stomach adenocarcinoma has been well studied (7,9,12), there are very few studied explaining the association of a lymph node based non Hodgkin lymphoma and a stomach adenocarcinoma (13,14,15). In these cases, the incidence of epithelial neoplasms is so low that it is difficult to distinguish the risk from that of the general population (5).
The association of a second neoplasms in lymphoma patients brings up several problems, like the possibility of a role of the chemotherapy and radiotherapy treatment in the development or more aggressive course of the second neoplasm, and the difficult management of a patient that may be cured of his/her lymphoma and presents with a new neoplasm.
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