Harmonic is a European-funded project that aims at better understanding the long-term health effects of medical exposure to ionising radiation in children, specifically cancer patients treated with modern radiotherapy techniques and cardiac patients treated with X-ray guided imaging procedures


The use of radiation for medical diagnosis and treatment procedures has had a major impact on the survival of paediatric patients. Although the benefits of these techniques largely outweigh the risks, there is a need to better understand the long-term health effects of such exposures in order to optimise treatment plans in these young patients and reduce the risk of late toxicities.


By building European cohorts and registries for long-term follow up of paediatric patients, we aim to:

Investigate the late health effects of ionising radiation in children.
Provide the medical and radiation protection communities with tools for long-term follow-up of children exposed to medical radiation.
Improve estimates of radiation doses to specific organs.
Investigate possible biological mechanisms leading to the development of late adverse health effects.
Establish recommendations to optimise radiotherapy and cardiac fluoroscopy treatments and further reduce radiation doses.


Provide much-needed
information on the effects
of low to moderate doses
of radiation on humans

Help improve radiological
protection in medicine

Impact on patient care
and quality of life


Harmonic aims at better understanding the health effects of exposure to medical ionising radiation in children, specifically cancer patients treated with modern radiotherapy techniques, and cardiac patients treated with X-ray guided imaging procedure.

To achieve its objectives, the project is structured into 6 work packages (WPs): one WP on radiotherapy, one on cardiology, two interconnected WPs on dosimetry and biology, as well as 2 cross-cutting WPs that ensure the project’s coordination as well as the communication and dissemination of its goals and results.



WP1 Coordination

(Lead: ISGlobal). WP1 is devoted to the overall management of the project, including liaison with the EU and partners. This WP will ensure timely provision of results and adherence to the European Code of Conduct for Research Integrity, monitor ethical issues that may arise, and cover consortium management issues, including financial, administrative and legal aspects of the project.


WP2 Radiotherapy

(Lead: INSERM/UK Essen). This WP aims at building a registry of paediatric patients treated with modern radiotherapy techniques in Europe, in order to provide the medical community with an infrastructure to investigate medium and long-term effects. Specifically, it aims to:

  • Set-up a pan-European registry of paediatric patients treated with particle therapy
  • Assess endocrine dysfunctions, cardiovascular toxicities, neurovascular damages, and secondary cancers after proton and photon therapy
  • Assess the impact of radiotherapy on the medium and long-term quality of life, and social and academic outputs of these paediatric patients


WP3 Cardiac catheterization

(Lead: UNEW/IRSN). The main objective of this WP is to investigate the association between early-life exposure to ionising radiation and risk of cancer by building a large retrospective cohort of paediatric patients that have undergone cardiac fluoroscopy procedures. procedures. The specific objectives are:

  • Build a joint cohort of paediatric patients exposed to cardiac catherization
  • Estimate the dose response relationship between radiation exposure and health effects
  • Investigate modifying factors of this association


WP4 Dosimetry

(Lead: SCK.CEN). WP4 aims at estimating radiation doses delivered to the whole body and specific organs. The specific objectives are:

  • In radiotherapy, study the dose distribution absorbed by the whole body, with emphasis on organs of interest
  • In interventional cardiology, develop methods for dose assessment for epidemiological investigations and to help optimise doses in the clinics


WP5 Biology

(Lead: SU). The main goal of this WP is to investigate the mechanisms and identify possible biomarkers of radiation-induced health effects, focusing particularly on oncogenic processes and vascular diseases. Specifically, it aims to:

  • Identify radiation-induced cellular responses in blood and saliva samples that may lead to cancer and vascular diseases
  • Identify biomarkers of sensitivity and health effects that may help identify patients at higher risk and/or may be used in epidemiological studies
  • Evaluate differences in disease biomarkers depending on the radiation delivery technique, beam quality factors, or the type of radiation particle (photon, proton, neutron)


WP6 Communication and Dissemination

(Lead: ISGlobal). The main objective of this WP is to maximise the impact of the project during and beyond its lifespan. It will do so by:

  • Developing communication materials and tools
  • Disseminating and explaining the project’s aims and results to different target audiences
  • Engaging the relevant stakeholders to ensure that the findings contribute to evidence-based recommendations on radioprotection