Late effects of treatment study continues sustained academic effort in Hodgkin's lymphoma

Early diagnosis, targeted therapeutics, and more personalized multimodal treatments have boosted survival rates of patients with cancer and have led to a large and rapidly increasing number of cancer survivors. This is particularly true for patients with Hodgkin's lymphoma, where successive EORTC trials have registered continuous progress in the development of treatment strategies for this disease.

However, survivors of Hodgkin lymphoma are at risk of developing various late complications, the heart being one of the organs most often affected. Now, in a paper appearing in a recent issue of Lancet Haematology, researchers, on behalf of the EORTC Lymphoma Group, show that an increased risk of cardiovascular disease is quantified at specific dose levels of radiation as well as anthracycline exposure.

Dr. Maja V. Maraldo at Rigshospitalet in Copenhagen and corresponding author of this paper says, "These study results are exciting. They should allow physicians to optimize the combination of systemic therapy and radiation and thereby balance the risks and benefits of different regimens in individual patients."

Indeed, cardiovascular disease following treatment is an important concern in cancer survivors, but our understanding of cardio-toxicity is limited by the retrospective nature of data. Here, however, the EORTC researchers were able to perform a detailed analysis of nine collaborative EORTC-LYSA trials conducted between 1964 and 2004 by the EORTC Lymphoma Group and from 1993 by the Groupe d'Etude des Lymphomes de l'Adulte (GELA, now renamed as LYSA) across 13 European countries. Information on primary treatment was complete for 6039 Hodgkin's lymphoma survivors at a median follow-up of 9 years, and the cardiovascular disease risk was able to be addressed in a more individual manner.