Specific doses of radiation and anthracycline use were linked to increased cardiovascular risk in survivors of patients with Hodgkins lymphoma, according to an article published in The Lancet Haematology.1

Cardiovascular disease following cancer treatment is of concern to cancer survivors, but knowledge of cardiotoxicity following treatment exposure is limited.

As a result, investigators on behalf of the European Organisation for Research and Treatment of Cancer (EORTC) Lymphoma Group performed a retrospective analysis to assess late-onset effects of anthracyclines, vinca-alkaloids, and radiotherapy in patients who were included in nine successive European Hodgkin’s lymphoma trials between 1964 and 2004.

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Investigators developed a Life Situation Questionnaire (LSQ) and applied Cox proportional hazards regression analyses to quantify the effects of treatment on cardiovascular risk.

A total of 1,919 patients responded to the LSQ. Results showed that 703 patients had 1,238 first cardiovascular events, most of which were ischemic heart disease (19%), congestive heart failure (12%), arrhythmia (16%), and valvular disease (11%).

Results identified a mean heart radiation dose per 1 Gy increase (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) as significant predictors of cardiovascular disease.

RELATED: Cardiovascular Effects of Chemo-Radiation in Hodgkin’s Lymphoma Analyzed

Cumulative doses of vinblastine, vincristine, and mean radiation dose to the left or right of the internal carotid artery were not linked with cardiovascular events.

The findings “will enable a quantitative assessment of the optimum combination of systemic therapy and radiation, which will help clinicians to balance the risks and benefits of different regimens for individual patients,” the authors concluded.


  1. Maraldo MJ, 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 Haematol. doi: 10.1016/S2352-3026(15)00153-2.