Health effects of ionising radiation in paediatrics undergoing either cardiac fluoroscopy or modern radiotherapy (The HARMONIC project)

Isabelle Thierry-Chef (1) , Beate Timmermann (2) , Neige Journy (3, 4) , Marie-Odile Bernier (5) , Richard Mcnally (6) , Jérémie Dabin (7) , Lorenzo Brualla (2) , Siamak Haghdoost (8, 9, 10) , Adelaida Sarukhan (11) , Karin Haustermans (12, 13) , Inge de Wit (14) , Sofie Isebaert (14) , Yasmin Lassen-Ramshad (15) , Louise Tram Henriksen (15) , Morten Høyer (16) , Laura Toussaint (16) , Guillaume Boissonnat (17) , Juliette Thariat (18) , Charlotte Demoor-Goldschmidt (4) , Nadia Haddy (4, 19) , Stéphanie Bolle (20, 21) , Brice Fresneau (22, 23) , Amel Belhout (4, 22) , Steffen Dreger (24) , Hajo Zeeb (25) , Maria Grazia Andreassi (26) , Jonica Campolo (27) , Eugenio Picano (28) , Andreas Jahnen (29) , Cécile Ronckers (30) , John H Maduro (31) , Kristina Kjaerheim (32) , Gaute Døhlen (33) , Trude Eid Robsahm (34) , Hilde M Olerud (35, 36) , Utheya Salini Thevathas (35, 36) , Susmita Afroz (35, 36) , Bjørn Helge Østerås (37) , Uwe Schneider (38) , Linda Walsh (38) , Agnès Dumas (39, 20, 4) , Angéla Jackson (39, 20, 4) , Estelle Rage (5) , Marijke de Saint-Hubert (7) , Richard Hardy (6) , Christian Bäumer (2) , Theresa Steinmeier (40) , Suzan Botzenhardt (40) , Martina Wette (40) , Rodney Ortiz (1) , Vadim Chumak (41)

1 ISGlobal - Instituto de Salud Global - Institute For Global Health [Barcelona]
2 West German Cancer Center [Essen, Germany]
3 U1018
4 CESP - Centre de recherche en épidémiologie et santé des populations
5 IRSN/PSE-SANTE/SESANE/LEPID - Laboratoire d épidémiologie des rayonnements ionisants
6 Newcastle University [Newcastle]
7 SCK-CEN - Centre d'Etude de l'Energie Nucléaire
8 The Wenner-Gren Institute
9 ARIA - Accueil et Recherche en Radiobiologie des Ions Accélérés
10 CIMAP - UMR 6252 - Centre de recherche sur les Ions, les MAtériaux et la Photonique
11 Barcelona Institute of Global Health (ISGlobal), Universitat Pompeu Fabra (UPF), Barcelone, Spain
12 University Hospitals Leuven [Leuven]
13 Department of Oncology [Leuven, Belgium]
14 KU Leuven - Catholic University of Leuven = Katholieke Universiteit Leuven
15 Aarhus University Hospital
16 Aarhus University [Aarhus]
17 LM2S (CEA, LIST) - Laboratoire Modélisation et Simulation de Systèmes (CEA, LIST)
18 UNICANCER/CRLC - Centre Régional de Lutte contre le Cancer François Baclesse [Caen]
19 Direction de la recherche clinique [Gustave Roussy]
20 IGR - Institut Gustave Roussy
21 Département de radiothérapie [Gustave Roussy]
22 U1018 (Équipe 3) - Épidémiologie des radiations, épidémiologie clinique des cancers et survie
23 Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy]
24 (BIPS) - Leibniz Institute for Prevention Research and Epidemiology
25 Health Sciences Bremen, University of Bremen
26 CNR-IFC : National Research Council-Institute of Clinical Physiology
27 Institute of Clinical Physiology, CNR
28 Istituto di Fisiologia Clinica del CNR
29 LIST - Luxembourg Institute of Science and Technology
30 University Medical Center, Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)
31 University of Groningen [Groningen]
32 Cancer Registry of Norway
33 Department of Pediatric Cardiology, Oslo University Hospital
34 Cancer Registry of Norway
35 Norwegian Radiation and Nuclear Safety Authority
36 Faculty of Health and Social Sciences, University of South-Eastern Norway
37 NTNU - Norwegian University of Science and Technology [Oslo]
38 UZH - Universität Zürich [Zürich] = University of Zurich
39 ECEVE (U1123 / UMR_S_1123) - Epidémiologie Clinique et Evaluation Economique Appliquées aux Populations Vulnérables
40 AöR - University Hospital Essen
41 NRCRM - National Research Center for Radiation Medicine

The use of ionising radiation (IR) for medical diagnosis and treatment procedures has had a major impact on the survival of paediatric patients. Although the benefits of these techniques lead to efficient health care, evaluation of potential associated long-term health effects is required. HARMONIC aims to better understand the increased risk of cancer and non-cancer effects after exposure to medical IR in children with cancer treated with modern external beam radiotherapy (EBRT) – radiation energy in MeV range – and in children with cardiac defects diagnosed and treated with cardiac fluoroscopy procedures (CFP) – radiation energy in keV range. The project investigates, among survivors of paediatric cancer, potential endocrine dysfunction, cardiovascular and neurovascular damage, health-related quality of life and second (and subsequent) primary cancer (SPC). The cardiac component builds a pooled cohort of approximately 90 000 paediatric patients who underwent CFP during childhood and adolescence to investigate cancer risk following exposure to IR and explore the potential effects of conditions predisposing to cancer. HARMONIC develops software tools to allow dose reconstruction in both EBRT and CFP to enable epidemiological investigations and future optimisation of treatments. With the creation of a biobank of blood and saliva samples, HARMONIC aims to provide a mechanistic understanding of radiation-induced adverse health effects and identify potential biomarkers that can predict these effects.

Mots clés: ionizing radiation; radioactivity; dosimetry; cancer; diagnosis; medical diagnosis; paediatric cancer; radiotherapy; cardiac fluoroscopy procedures; endocrine dysfunctio; radioinduced cancer; patient cohort; dose reconstruction; modelling; epidemiological investigation; cancer treatment optimization; blood biobank; saliva biobank; radiation-induced adverse health effects; biomarkers

Domaines: Physique Médicale [physics.med-ph]; Cancer; Santé publique et épidémiologie

Isabelle Thierry-Chef, Beate Timmermann, Neige Journy, Marie-Odile Bernier, Richard Mcnally, et al.. Health effects of ionising radiation in paediatrics undergoing either cardiac fluoroscopy or modern radiotherapy (The HARMONIC project). EPJ N - Nuclear Sciences & Technologies, 2023, 9, pp.22. ⟨10.1051/epjn/2023009⟩. ⟨hal-04195751⟩