Breaking Traditions: Evaluating Single Fraction Radiation in Indolent Lymphoma

As indolent non-Hodgkin's lymphomas (iNHLs) are very radiosensitive, radiation treatment (RT) has been established as an essential curative and palliative modality for early and advanced stages of the disease. Several studies have explored the role of very low-dose RT for palliation in indolent non-Hodgkin's lymphomas, demonstrating that this approach can lead to high rates of local control, and thereby, help improve the quality of life for these patients. While the most common schedule of very low-dose RT used in the palliative setting is 4Gy in 2 fractions, which was established in the landmark FoRT trial, this requires patients to be available for two RT sessions, increasing the financial and opportunity costs for the patient. Currently, data regarding the use of a single fraction of very low-dose RT (4Gy) for treating iNHLs in the palliative setting is still lacking. In this viewpoint, we aim to draw attention to this approach, where we emphasize the need for further exploration of the single-dose fractionation schedule as a non-toxic, simple, and easy treatment approach for iNHLs, which would inform future clinical trials to investigate this dose/fractionation.