Balancing benefits and risks of radiotherapy in Hodgkin lymphoma
Radiotherapy for Hodgkin lymphoma improves disease control but has risks of long-term side effects that need to be balanced against this proven benefit. This can be challenging as these side effects may not occur for many years, even decades, are the treatment is given.
We performed a study that used radiation doses from a randomised clinical trial, our dose-responses for radiation-related heart disease and contemporary population-based rates of cardiovascular disease, to produce estimates of the risk of future radiation-related heart disease and help inform how to make this balance in clinical practice.
We also used Health Economic modelling to assess the overall outcome of treatment for Hodgkin lymphoma using chemotherapy alone versus treatment with both chemotherapy and radiotherapy including the risks of late effects into a single measure (quality-adjusted life years, QALYs). Treatment with radiotherapy was found to be more favourable, except in smokers.