HARMONIC is a consortium of 25 partner institutions that have built two critical cohorts of paediatric patients exposed to ionising radiation during treatment of cancer and cardiac defects. It provides medical professionals and the radiation protection community with the necessary framework and tools to assess the effects of IR exposure on children, adolescents and young adults. By doing so, HARMONIC advances the understanding of long-term sequelae, ensuring they are considered and integrated into patient care and follow-up.
HARMONIC-RT established the first pan-European registry dedicated to paediatric patients who have undergone modern radiotherapy techniques, specifically proton or photon therapies. This initiative aims to provide valuable insights to the medical community regarding potential endocrine disorders, as well as cardio- and neurovascular sequelae, in addition to assessing the quality of life and social implications associated with contemporary radiotherapy methods. To date, more than 2,300 cancer patients treated EBRT since the year 2000 have been meticulously recorded through both prospective and retrospective data collection methods and task-specific analysis plans have been developed to guide future data assessment and research endeavours.
In parallel, the joint HARMONIC-Cardio database containing about 60 000 patients aged less than 22 years old exposed to Ionizing radiation through CFP has been built based on collection of data in 7 European countries: Belgium, France, Germany, Italy, Norway, Spain and UK. Analyses on the risk of cancer compared to thus observed in the general population has been performed, based on standardized incidence ratio (SIR). Impact of predisposing factors on the SIR estimates has been assessed.
Strategies for dose reconstruction were established for both cohorts. These rely on newly developed computational frame works and software tools, which were benchmarked against existing tools, when available, and validated against new measurements on anthropomorphic phantoms. Organ doses are estimated to further investigate the dose response relationship for each outcome of interest.
Enrolment of the patients from each of the two cohorts and collections of blood and saliva samples was achieved in Italy, France, Denmark and Belgium. A set of analyses was performed: plasma protein profiles, saliva protein profiles, miRNA analysis, telomere length measurements, determination of post translation changed of proteins using RPPA and detention of mitochondrial copy numbers. The promising first results will be verified with deep biostatistical analysis.
