Trial reportJournal of clinical oncology : official journal of the American Society of Clinical Oncology2021
Predicted Risks of Cardiovascular Disease Following Chemotherapy and Radiotherapy in the UK NCRI RAPID Trial of Positron Emission Tomography-Directed Therapy for Early-Stage Hodgkin Lymphoma.
Trial report in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 33 citations in OpenAlex.
- Late Cardiac Toxicity After Anthracyclines and Radiotherapy for Lymphoma-A Regression Analysis of Dose-Response.Hematological oncology · 2025Pooled it
- Radiation exposure of breast tissue in lymphoma radiotherapy: a systematic review of breast dose metrics published since 2000.Acta oncologica (Stockholm, Sweden) · 2025Pooled it
- Positron emission tomography-adapted therapy for first-line treatment in adults with Hodgkin lymphoma.The Cochrane database of systematic reviews · 2025Pooled it
- Chemotherapy alone versus chemotherapy plus radiotherapy for adults with early-stage Hodgkin's lymphoma.The Cochrane database of systematic reviews · 2024Pooled it
- Review
- Consolidation radiotherapy refusal in stage I-II Hodgkin lymphoma: sociodemographic determinants and impact on survival outcomes.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026Article
- Nanomaterials reshaping cancer radiotherapy: Radiosensitization mechanisms, delivery and theranostic platforms, multimodal synergy, and clinical translation strategies.Materials today. Bio · 2026Review
- Hodgkin lymphoma: EHA Clinical Practice Guidelines for diagnosis, treatment, and follow-up.HemaSphere · 2026Article
- Comparing Organs at Risk Sparing Between Intensity-Modulated Radiotherapy and Pencil-Beam Scanning Plans Based on Disease Location for Hodgkin and Non-Hodgkin Lymphoma.International journal of particle therapy · 2026Article
- Recent advances in phototherapy-based nanomedicine of lymphoma.Materials today. Bio · 2025Review
- Cardiovascular Disease Mortality Risk among Long-term Survivors of Different Hodgkin Lymphoma Types.Reviews in cardiovascular medicine · 2025Article
- Newly Diagnosed Classical Hodgkin Lymphoma: Optimizing Outcomes in a New Therapeutic Era.Hematological oncology · 2025Review
- Assessment of cardiac radiation dose in the Co-60 prone-based stereotactic partial breast irradiation using distance metrics.Frontiers in oncology · 2025Article
- Article
- Cardiovascular disease incidence rates: a study using routinely collected health data.Cardio-oncology (London, England) · 2023Article
- Review
- Predicted cardiac and second cancer risks for patients undergoing VMAT for mediastinal Hodgkin lymphoma.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2023Article
- Individualised Estimation of Quality-adjusted Survival Benefit and Cost-effectiveness of Proton Beam Therapy in Intermediate-stage Hodgkin Lymphoma.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2023Article
- [Cardiovascular risk evaluation in the treatment of Hodgkin lymphoma-are we on the road to individualized planning?]Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2023Article
- Optimised conformal total body irradiation: a heterogeneous practice, so where next?The British journal of radiology · 2023Review
Corrections and comments
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Authors and funding
11 authors at 6 institutions in 1 country.
Funding
Abstract
purposeThe contemporary management of early-stage Hodgkin lymphoma (ES-HL) involves balancing the risk of late adverse effects of radiotherapy against the increased risk of relapse if radiotherapy is omitted. This study provides information on the risk of radiation-related cardiovascular disease to help personalize the delivery of radiotherapy in ES-HL.
methodsWe predicted 30-year absolute cardiovascular risk from chemotherapy and involved field radiotherapy in patients who were positron emission tomography (PET)-negative following three cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine chemotherapy within a UK randomized trial of PET-directed therapy for ES-HL. Cardiac and carotid radiation doses and chemotherapy exposure were combined with established dose-response relationships and population-based mortality and incidence rates.
resultsAverage mean heart dose was 4.0 Gy (range 0.1-24.0 Gy) and average bilateral common carotid artery dose was 21.5 Gy (range 0.6-38.1 Gy), based on individualized cardiovascular dosimetry for 144 PET-negative patients receiving involved field radiotherapy. The average predicted 30-year radiation-related absolute excess overall cardiovascular mortality was 0.56% (range 0.01%-6.79%; < 0.5% in 67% of patients and > 1% in 15%), whereas average predicted 30-year excess incidence was 6.24% (range 0.31%-31.09%; < 5% in 58% of patients and > 10% in 24%). For cardiac disease, the average predicted 30-year radiation-related absolute excess mortality was 0.42% (0.79% with mediastinal involvement and 0.05% without) and for stroke, it was 0.14%.
conclusionPredicted excess cardiovascular risk is small for most patients, so radiotherapy may provide net benefit. However, for a minority of patients receiving high doses of radiation to cardiovascular structures, it may be preferable to consider advanced radiotherapy techniques to reduce doses or to omit radiotherapy and accept the increased relapse risk. Individual assessment of cardiovascular and other risks before treatment would allow personalized decision making about radiotherapy in ES-HL.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.