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Recommendations for Radiotherapy Technique and Dose in Extra-nodal Lymphoma.

P J Hoskin1, P Díez1, E Gallop-Evans2

  • 1Mount Vernon Cancer Centre, Northwood, Middlesex, UK.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|October 13, 2015
PubMed
Summary

This study outlines radiation therapy guidelines for non-Hodgkin lymphoma affecting sites outside lymph nodes. It details target volume delineation and dose prescriptions for effective treatment of extra-nodal lymphoma.

Keywords:
Extra-nodalHodgkinlymphomanon-Hodgkinradiotherapy

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Area of Science:

  • Radiation Oncology
  • Hematologic Malignancies
  • Medical Physics

Background:

  • Extra-nodal involvement occurs in approximately 40% of non-Hodgkin lymphoma cases.
  • Standardized guidelines are crucial for consistent and effective radiation therapy in these complex cases.

Purpose of the Study:

  • To present general principles for clinical target volume delineation in extra-nodal lymphoma.
  • To provide specific examples and dose recommendations for radiation therapy in extra-nodal lymphoma.

Main Methods:

  • Encompass the entire affected organ within the clinical target volume, with a minimum 10 mm expansion.
  • Account for lymphatic flow patterns when determining expansion margins.
  • Utilize standard nodal irradiation techniques for adjacent lymph nodes.

Main Results:

  • Recommended doses: 30 Gy in 15 fractions for Hodgkin and aggressive non-Hodgkin lymphoma.
  • Recommended doses: 24 Gy in 12 fractions for indolent lymphomas.
  • Exceptions noted for palliative cases, mycosis fungoides, CNS lymphoma, and NK/T-cell lymphoma.

Conclusions:

  • Established principles for target volume delineation and dose prescription ensure consistent radiation therapy for extra-nodal lymphoma.
  • These guidelines aim to optimize treatment efficacy while considering specific disease characteristics and locations.