Certain doses of radiation and anthracycline therapy for the treatment of Hodgkin’s lymphoma may increase the risk of cardiovascular events, according to a retrospective analysis published in Lancet Haematology.1

A Life Situation Questionnaire (LSQ) was mailed to patients who were enrolled in the European Organisation for Research and Treatment of Cancer (EORTC) and Groupe d’Etude des Lymphomes de l’Adulte (GELA or LYSA) trials from 1964 to 2004.

Of the 6,039 patients whose information on primary treatment was obtained, 1,919 responded to the LSQ. In 703 patients, 1,238 first cardiovascular events were recorded: ischemic heart disease (19%), congestive heart failure (12%), arrhythmia (16%), and valvular disease (11%).

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Cumulative doses of vinblastine (P=.77) and vincristine (P=.36), and mean radiation dose to the left (P=.41) or right (P=.70) internal carotid artery did not serve as predictors for cardiovascular events.

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The mean heart radiation dose per 1 Gy increase (hazard ratio [HR] 1.015; 95% CI, 1.006-1.024; P=.0014), and the dose of anthracyclines per 50 mg/m2 increase in cumulative dose (HR, 1.077; 95% CI, 1.021-1.137; P=.0064) significantly impacted the risk of cardiovascular disease development.

Investigators concluded that quantification of cardiovascular risk with specific doses of chemo-radiation will allow for health care providers to further individualize regimens for patients.


  1. Maraldo MV, Giusti F, Vogelius IR, et al. Cardiovascular disease after treatment for Hodgkin’s lymphoma: an analysis of nine collaborative EORTC-LYSA trials [published online ahead of print October 14, 2015] Lancet. doi: 10.106/S2532-3026(15)00153-2.