Radiation Therapy Techniques For Leukemia And Lymphomas
A variety of irradiation techniques have been used in patients with Hodgkin’s Disease and NHL. One of the most common techniques was a “Mantle Field” which encompassed the mediastinum, bilateral supraclavicular, infraclavicular, axillary and cervical lymph nodes. A “Mini-Mantle” included all the above lymph node chains except the mediastinum.
Mini-Mantle Radiotherapy Fields
Today, more localized ‘involved’ fields are more commonly used, encompassing solely the involved lymph node chains and occasionally the adjacent uninvolved sites. Total doses range from 20-40 Gy delivered over 2-4 weeks.
Newer radiotherapy techniques, such as intensity modulated radiation therapy (IMRT), are not commonly used in patients with Hodgkin’s Disease and NHL given the low doses required. However, select lymphoma patients may benefit from IMRT notably patients with tumors arising in head and neck sites (adjacent to radiosensitive salivary glands) and those with bulky tumors in the para-aortic regions (adjacent to the kidneys).
IMRT treatment plan in a patient with stage IA NHL of the right neck
Note sparing of the right parotid gland.