The goal of the HARMONIC-RT study is to evaluate late health and social outcomes of contemporary techniques of external beam radiotherapy in paediatric patients, based on the setting-up of a European, long-term registry complemented by a biobank.
Specific objectives: * To develop the infrastructure and instruments for setting-up a European, long-term registry of paediatric patients treated with contemporary techniques of modern external radiotherapy; * To assess the incidence and severity of late health outcomes, primarily endocrine dysfunctions, cardiovascular toxicities, neurovascular damages, and subsequent primary neoplasms, in relation to the dose-volume distribution to non-targeted organs and tissues, radiation delivery technique and beam quality factors, and potential modifying factors (i.e. age at exposure, genetic predispositions, comorbidities, and systemic treatments including chemotherapy, targeted therapy, immunotherapy and hormonal drugs) that may underlie differences in individual susceptibility for these outcomes ; * To assess societal aspects of advances in radiotherapy, primarily health-related quality of life and academic achievement, in paediatric patients treated with modern external radiotherapy techniques. Secondary scientific objectives: * To assess multidimensional fatigue in paediatric patients treated with modern external radiotherapy techniques, and identify clinical and therapeutic determinants of fatigue; * To improve estimation of patient-specific doses to the whole body and non-targeted organs and substructures from different radiotherapy delivery techniques; * To investigate radiation-induced cellular responses and biological mechanisms related to the occurrence of vascular diseases and subsequent primary neoplasms in samples of blood and saliva ; to identify biomarkers of susceptibility and health effects ; to evaluate differences in disease biomarkers in relation to the radiation delivery technique and beam quality factors ; to explore the relevance of the use of saliva as a biosampling method for paediatric cohorts regarding feasibility and the quality and reproducibility for different measured biomarkers. Secondary strategic objectives: * To promote sustained collaborative research activities for improvement of patient care, and inform health care providers and policy makers on the clinical and social impact of advances in radiotherapy in paediatric settings; * To serve as a pilot for a future long-term pan-European registry of children and adolescents treated with particle and photon beam therapy, including a biobank of saliva and blood samples collected before and after treatment; * To contribute in future collaborative projects with existing cohorts or registries in Europe * To contribute in future international research studies on late outcomes of modern radiotherapy techniques for management of paediatric cancers Funding: The HARMONIC project has received funding from the Euratom research and training programme 2014-2018 under grant agreement No 847707.
Study Type
OBSERVATIONAL
Enrollment
2,670
No intervention
KU Leuven
Leuven, Belgium
RECRUITINGAarhus University hospital
Aarhus, Denmark
RECRUITINGCentre Régional François Baclesse
Caen, France
RECRUITINGEndocrinopathies
Late health outcomes
Time frame: up to 20 years after RT
Cardiovascular diseases
Late health outcomes * Neurovascular diseases * Second and subsequent primary neaoplasms
Time frame: up to 20 years after RT
Neurovascular diseases
Late health outcomes
Time frame: up to 20 years after RT
Second and subsequent primary neaoplasms
Late health outcomes
Time frame: up to 20 years after RT
Health-related quality of life (physical, emotional, social, and school functioning) assessed by the PedsQL™ core scale (validated questionnaire)
Late social outcomes
Time frame: up to 10 years after radiation therapy or attained age 25 years, whichever occurs first
Academic achievement
Late social outcomes
Time frame: up to 10 years after radiation therapy or attained age 25 years, whichever occurs first
Dysfunctions in endocrine hormone levels
measured as: 1. insulin-like growth factor-1, 2. anterior pituitary hormones (GH, ACTH, TSH, LH, FSH), 3. thyroid hormones (fT3, fT4), 4. sexual hormones
Time frame: up to 10 years after radiation therapy
Changes in blood markers of cardiovascular diseases
measured as blood markers (incl. troponin, BNP, CPK)
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Gustave Roussy
Villejuif, France
RECRUITINGUniversity Hospital Essen, The West German Proton Therapy Centre Essen
Essen, Germany
RECRUITINGTime frame: up to 10 years after radiation therapy
Changes in imaging markers of cardiovascular diseases
measured as cardiac echography parameters (incl. ejection fraction, diastolic function)
Time frame: up to 10 years after radiation therapy
Changes in imaging markers of neurovascular damages
measured as scoring of large and small vessel damages
Time frame: up to 5 years after radiation therapy
Changes in blood/saliva markers of protein activation relating to vascular damages
measured as signal quality of protein activity
Time frame: up to 1 year after radiation therapy
Changes in blood/saliva markers of oxidative stress response
measured as markers of oxidative stress (incl. 8-oxo-dG, SOD2, DNA repair enzymes)
Time frame: up to 1 year after radiation therapy
Changes in blood/saliva markers of inflammatory response
Inflammatory markers (incl. PTX3, CRP, NF-kB, IL-1 and IL10)
Time frame: up to 1 year after radiation therapy
Changes in blood/saliva markers of carcinogenesis
Markers of carcinogenesis (incl. leukocyte telomere length, mitochondrial DNA copy number, circulating microRNA)
Time frame: up to 1 year after radiation therapy
Multidimensional fatigue (general, sleep/rest, and cognitive fatigue)
PedsQL™ multidimensional fatigue scale (validated questionnaire)
Time frame: up to 10 years after radiation therapy or attained age 25 years, whichever occurs first
Clinical events other than those mentioned as primary outcomes
Late morbidity
Time frame: up to 20 years after radiation therapy
All-cause and cause-specific mortality
Late mortality
Time frame: up to 20 years after radiation therapy