Good things come in small packages: low-dose radiation as palliation for indolent non-Hodgkin lymphomas.
Numerous management options are available to patients with advanced-stage or relapsed/refractory indolent non-Hodgkin lymphomas (NHLs). These include observation in patients with low-volume disease, systemic therapy including radioimmunotherapy, and high-dose therapy with stem cell transplant. In selected patients with localized symptomatic disease, local radiation therapy to sites of involvement can offer effective palliation. However, systemic therapy and standard-dose radiation therapy can be associated with significant toxicities. Over the past 15 years, several groups have investigated the role of low-dose radiation therapy--typically 4 Gy in two fractions--to an involved-field as an option for palliation in patients with NHL. Overall response rates of more than 80% have been consistently reported with local control maintained for 2 years. In this review, we outline the clinical experience with this approach in NHL of various histologies.
Martin
Neil E
NE
Harvard Radiation Oncology Program, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, MA 02115, USA.
Ng
Andrea K
AK
D000505:Alopecia / Q000209:etiology; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D017495:Hyperpigmentation / Q000209:etiology; D008228:Lymphoma, Non-Hodgkin / Q000473:pathology / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome