Radiation and Hodgkin's Lymphoma

For patients with early-stage Hodgkin's lymphoma, radiation therapy has long been part of the successful treatment plan.

This is changing, as doctors look for ways to maintain the efficacy in treating this disease while reducing the toxicity profile. Lately, the place they have been looking to do that is in the application of radiation therapy.

The Traditional Role

Traditionally, the idea has been to see whether radiation therapy can be reduced in treating Hodgkin's lymphoma, and the reasons are thus: Radiotherapy comes with a risk of cardiac toxicities, as well as secondary cancers many years down the road-- a particular problem for young women with Hodgkin's who receive chest irradiation, as they have been found to be at a much higher risk for breast cancer than the general population.

Therefore many doctors will avoid administering radiation to younger patients so as to avoid these risks. For older patients, however, who have early-stage Hodgkin's, many doctors do not have these same reservations, and the reason is because the side effects mentioned above are very long-term (two to three decades) and in older patients they simply don't have the time necessary to become a problem.

A New Role for Radiation

According to Anas Younes, MD., radiation therapy still has a vital role to play in frontline treatment of Hodgkin's along with the combination chemotherapy regimen ABVD, in cases where complete remission following ABVD isn't achieved. Dr. Younes believes that radiotherapy in this setting has the potential to spare patients from either having to have a stem cell transplant or second-line chemotherapy options.

On top of that, radiation therapy has changed substantially in the past 20-30 years. Today, modern radiation therapy can be administered to areas of the chest and mediastinum that actually will avoid areas such as the heart and the breast. By eliminating these risks, radiation therapy is much more appealing.

Radiation fields can now be adjusted and individualized for each patient, minimizing risks and maximizing therapeutic value.

Source: OncLive: Role of Radiation Therapy in Hodgkin's