Neurologic Morbidity in Survivors of Childhood Hodgkin Lymphoma Treated With Radiation

BACKGROUND: Hodgkin lymphoma is the most common cancer in adolescence and is treated with chemotherapy and/or radiation therapy. Little is known about neurologic symptoms, signs, and morbidity in long-term survivors of childhood Hodgkin lymphoma that were treated with radiation. The aim of this study was to identify neurologic symptoms, signs, and related morbidity in survivors of childhood Hodgkin lymphoma who received radiation therapy. METHODS: Long-term survivors (≥5 years from diagnosis, ≤25 years at diagnosis, and ≥18-years old at study enrollment) and community controls matched for age, sex, and ethnicity were recruited and provided written consent. Participants answered a questionnaire, followed by a face-to-face interview and examination by a neurologist. All survivors were treated with chemotherapy and thoracic/neck radiation therapy. RESULTS: The study questionnaire and face-to-face interview were completed by 197 survivors and 191 controls. Male-to-female ratio was 94:103 in survivors and 95:96 in controls. Median age at tumor diagnosis was 14.7 years (range: 3.0-22.6) and median time from tumor diagnosis was 20.9 years (range: 10.7-45.6 years). Headaches (43.2% vs. 32.8%), dizziness (38.1% vs. 19.9%), bladder and (15.8% vs. 9.4%) bowel problems (20.3% vs. 12.8%), and sensory neuropathy (22.1% vs. 5.8%) were more prevalent in survivors. Migraine headaches (32.0% vs. 22.9%) were more prevalent in female survivors but did not reach statistical significance. Neurologic morbidity and disability measures showed low associated morbidity. CONCLUSION: While survivors of childhood Hodgkin lymphoma treated with radiation experienced more neurologic symptoms when compared to controls, their neurologic morbidity was low. TRIAL REGISTRATION: NCT01820117.