Table 1 Dose-response relationships and organ-specific radiotherapy doses used in Hodgkin lymphoma (HL) example
From: Cardiovascular disease incidence rates: a study using routinely collected health data
CVD | Organ at risk | Relationship between radiation dose measure and relevant CVD | Organ-specific doses in HL example (Gy) | |||
|---|---|---|---|---|---|---|
Radiation dose measure | Model for relative increase in CVD rate | Reference | Average | Range | ||
Ischaemic heart disease | Whole heart | Mean dose to whole heart (MHD) | RR = 1 + ERR*MHD ERR = 0.20 if age_tx < 28 y ERR = 0.088 if 28 ≤ age_tx ≤ 36 y ERR = 0.042 if age_tx > 36 y | [7] | 7.8 | 0.8–24.0 |
Valvular heart disease | Heart valves | Weighted sum of mean doses to valves (sumVD) | RR = 1 + e(−5.02) x sumVD x e(0.075*sumVD) | [8] | 12.6 | 0.8–33.1 |
Cardiomyopathy and heart failure | Left ventricle | Mean dose to left ventricle (MLVD) | RR = 1 + e(−4.12) x MLVD x e(0.06*MLVD) + e0.97xdanthra danthra = 1 if 150 mg/m2 of anthracyclines are given danthra = 0 if no anthracyclines are given | [9] | 3.3 | 0.3–20.5 |
Stroke | Common carotid arteries | Mean dose to common carotid arteries (MDCCA) | RR = 1 + ERR x MDCCA ERR = 0.0684 if age_tx ≤ 20 y ERR = .0513 if 20 < age_tx ≤ 30 y ERR = .0244 if 30 < age_tx ≤ 40 y ERR = .0098 if age_tx > 40 y | [14] | 28.3 | 10.5–38.1 |
Other cardiovascular diseases | Various | Various | Dose-response relationships are not available for these diseases individually. As an approximation, a weighted average of the above models can be used, with the weights depending on the diseases and exposures under consideration. For this example, an average of the models for IHD and CHF was used | [15] | Average of MHD and MLVD | - |