The role of radiation therapy in patients with Hodgkin’s lymphoma

Abstract

The outcome of patients with Hodgkin's lymphoma (HL) has improved dramatically because of improvement of both chemotherapy and radiotherapy. The need for radiotherapy in the treatment of patients with HL has changed tremendously. At first, extensive radiation was the only treatment option; then limited irradiation was used in addition to chemotherapy. Whether chemotherapy alone can be sufficient remains to be determined. For patients with early-stage HL with or without risk factors, two to four cycles of relatively mild chemotherapy followed by radiotherapy limited to involved fields (20-30 Gy/10-15 fractions) is widely accepted. For patients with advanced-stage HL, powerful chemotherapy is indicated; when partial remission results, chemotherapy is followed by radiotherapy to residual abnormalities, using only a small margin. In the future, treatment will be tailored to individual patients based on prognostic factors (possibly including biologic markers) and accurate evaluation of response to treatment.

Experimental study of radiogenic heart damage using in vitro and in vivo animal models

“…The time course of radiogenic, morphological and functional changes was similar to that in other studies [5,3,15]. Interstitial collagen deposition is thought to be progressive [5,53,54]; our experiments indicate that no abnormality occurs earlier than 5-6 months post-irradiation, even if a large dose is applied.…”

“…Radiation-induced heart diseases (RIHD) including ischemic heart disease, congestive heart failure, electrical conduct defects and valve abnormalities are typically late consequences of radiotherapy, occurring many years or decades after treatment [1,2]. Substantial number of irradiated patients may suffer from late sideeffects, these develop after chest irradiation in childhood cancers, lung, esophageal or breast cancer or Hodgkin's lymphoma [3,4]. These often-unattributed complications cause deterioration in quality of life of long-surviving patients, extra health care costs, and lead occasionally to fatal outcomes.…”

Role of radiation therapy for Hodgkin’s lymphoma

“…В последние годы при локальной ЛХ после неинтен-сивной химиотерапии объем радиационной мишени боль-ше, чем при распространенной ЛХ -облучение вовле-ченных узлов после более интенсивных режимов лекар-ственного лечения и неполном ответе [19]. В рандомизи-рованном исследовании UKLG LY09 проанализированы результаты лечения 807 пациентов с ЛХ IIIB-IV стадии.…”