What is radiotherapy for lymphoma

In recent years, lymphoma has become one of the major diseases that endangers society and human health, and it has brought great pain and distress to humans. In order to reduce the incidence of lymphoma, we humans should master the methods of radiotherapy for lymphoma:

1. Radiation therapy for Hodgkin's disease

In addition to the stage, the principles of radiotherapy also need to consider factors such as the location of the lesion, pathology, and age. If the lesion of the IA patient is located in the right upper neck, the cloak field can be used alone because there is less chance of invasion under the diaphragm; if the lesion is located in the left neck, because invasion under the diaphragm is common, the irradiation range should include at least the abdominal aorta and spleen in addition to the cloak field. For example, in IB and IIB, if the pathology is of mixed cell type or lymphocyte deficiency type, it is best to add chemotherapy after irradiation of the whole lymph node area. For patients under 10 years old or over 60 years old, due to poor radiation tolerance, the radiation field should not be too large, and local irradiation is generally used.

(1) Radical tumor dose: The radical tumor dose used by a medical university cancer hospital is 45 Gy/6 weeks. For larger tumors that shrink slowly, the local dose can be increased to about 50 Gy.

(2) Preventive irradiation: For more than a decade, the Rosenberg-Kaplan hypothesis has been used to believe that tumors occur in a single center and mainly metastasize along the adjacent lymph nodes. Therefore, radiotherapy should not only include the area where the tumor is clinically found, but also preventive irradiation of the adjacent lymph node areas. This change in view has significantly improved the treatment effect of Hodgkin's disease.

(3) Selection of radiation: Currently, 60Co or 4-8MeV X-rays are mostly used.

2. Radiotherapy for non-Hodgkin's lymphoma

(1) Radical dose and radiotherapy principles for tumors: The optimal dose for non-Hodgkin's lymphoma is not as clear as that for Hodgkin's disease, and the doses used in many clinical reports are also very inconsistent. For diffuse non-Hodgkin's lymphoma, 40-50Gy/5-6 weeks can be given, and for follicular non-Hodgkin's lymphoma, the dose can be reduced as appropriate, especially for primary superficial lymph nodes. However, for diffuse histiocytic type, due to its insensitivity to radiation and prone to local recurrence, the local control dose should be 50-60Gy. If the mass is huge or remains after irradiation, a local additional dose of 5-10Gy is given. For primary head and neck, 45-55Gy can be given.

(2) Radiotherapy for intranodal non-Hodgkin's lymphoma: According to the histological prognosis and stage, the radiotherapy principles are as follows: ① Good prognosis, stage I and II: Most patients use simple radiotherapy, and it is recommended to use involved field irradiation, not necessarily extended field irradiation. ② Good prognosis, stage III and IV: Most patients use chemotherapy. If the lesion is larger than 7-10 cm before treatment or the lesion cannot be completely eliminated after chemotherapy, local radiotherapy can be added. ③ Poor prognosis, stage I and II: Use intensive combined chemotherapy plus involved field irradiation, and then add combined chemotherapy after radiotherapy. ④ Poor prognosis, stage III and IV: This type of lymphoma develops rapidly, so intensive chemotherapy should be used in the early stage. If the lesion is not easy to completely eliminate, local radiotherapy can be added.

(3) Radiotherapy for extranodal non-Hodgkin's lymphoma: Early cases originating from the pharyngeal lymphatic ring can be controlled with radiotherapy. Radiotherapy should include the entire pharyngeal lymphatic ring and cervical lymph nodes. Generally, the tumor dose is 40-60 Gy. For lesions originating from the nasal cavity, the irradiation field includes the nasal cavity and the invaded paranasal sinuses. The nasopharynx is irradiated for prevention, with the anterior nasal field as the main field and the anterior field of the two ears as the auxiliary field. The radical dose of the tumor is 55 Gy/5-6 weeks, and the preventive dose is 40-45 Gy. For lesions originating from the maxillary sinus, the field setting is the same as that of maxillary sinus cancer, and the irradiation range is larger than that of maxillary sinus cancer. The radical dose of the tumor is 55 Gy/5-6 weeks. No surgical treatment is performed after radiotherapy. The effect of simple radiotherapy for primary abdominal malignant lymphoma is poor, and it is often used in combination with surgery or chemotherapy. Radiotherapy techniques vary depending on the location of the lesion. Whole abdominal irradiation, local regional irradiation, and tumor area irradiation can be performed.

The above is the method of radiotherapy for lymphoma. Expert Tip: If you have symptoms of illness, do not delay diagnosis and go to a regular hospital for treatment in time to avoid delaying the disease and causing serious consequences. If you have other questions, please consult our online experts or call for consultation.

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