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Importance of radiotherapy in management of Lymphoma

Trinanjan Basu

Malignant lymphomas are a set of diseases which have high potential for cure if managed adequately. The management of both Hodgkins and Non-Hodgkins lymphoma started with wide field / magna field radiotherapy. With the advent of highly potential systemic chemotherapy and later on monoclonal antibodies the cure rate improved and radiotherapy portals became smaller and focussed. Nowadays with the advent of further immunotherapy and pther effective biological drugs there is a tendency to eliminate radiotherapy in the overall management.
Radiotherapy techniques also have undergone mammoth changes in terms of field size, techniques and sparing normal structures. There are increasing use of involved field radiotherapy (IFRT) to involved site radiotherapy (ISRT) to involved nodal radiotherapy (INRT). Radiotherapy remains a mainstay in consolidative therapy in early stage as well as an effective local control modality in advanced bulky disease sites and extra nodal lymphomas.
We will be highlighting the importance of radiotherapy in the multimodality management of lymphomas with special emphasis on managing bulky disease and extra nodal sites. There will be latest guideline based take home message regarding ISRT and INRT and also ILROG guidelines for bulky disease. High grade lymphomas and extra nodal sites.