Low dose palliative radiotherapy in low grade non-Hodgkin's lymphoma

The clinical picture of disseminated (stage 3 and 4) low grade non-Hodgkin's lymphoma (NHL) is one of continuing relapse. Management options include observation only in asymptomatic patients, single agent chlorambucil or localised radiotherapy in patients with symptomatic nodal disease. Radiation doses of 25-40 Gray in 10-20 fractions have been the standard approach in low grade NHL, but in 1994 Ganem et al. [Hematol. Oncol. 8: 225-233, 1994] reported the use of low dose radiotherapy (LDRT)--4 Gray in 2 fractions over 3 days--for the palliation of symptomatic disease in patients with disseminated, chemoresistant low grade NHL. We describe here our early experience with this schedule.