Prognosis is favorable for patients with Hodgkin’s lymphoma (HL), and the 5-year survival is over 85% with treatment by chemotherapy and/or radiotherapy, but mantle field irradiation posed a high long-term risk of cardiovascular disease (CVD) 1-3. Cardiac death due to radiotherapy was a main cause of mortality among HL survivors 2. Such risk and the development of a second malignancy are increased after ten years, but early detection of these adverse consequences might reduce morbidity and mortality.1,2 This extended field radiotherapy was routinely used before 1990, involving the upper chest to treat early-stage (ES) HL, added to chemotherapy for more advanced stages 1-3. More recent standard management of ES-HL focuses on reducing late toxicity including two cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine and 20 Gy involved field radiotherapy resulting in 5-year survival with 90% relapse-free and 95% overall 2.
