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Hodgkin lymphoma

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Radiation therapy for Hodgkin lymphoma

Radiation therapy uses high-energy rays or particles to destroy cancer cells. Radiation may be used for Hodgkin lymphoma (HL):

  • as the primary treatment with chemotherapy to destroy cancer cells to reduce the risk of the cancer recurring
  • to shrink bulky tumours before chemotherapy
  • alone, in certain situations
    • for early stage favourable HL when the person cannot tolerate chemotherapy because of other health problems
    • when the HL is a small localized area and the lymph nodes are very small
    • for early stage nodular lymphocyte predominant HL without B symptoms
  • to control the symptoms of advanced HL (palliative radiation therapy)

The amount of radiation given during treatment, and when and how it is given, will be different for each person. The dose and schedule for the radiation therapy are determined by:

  • the extent of the disease
  • whether or not the radiation therapy is given with chemotherapy
  • whether the treatment is intended to be curative or palliative

External beam radiation therapy

HL is often treated with external beam radiation therapy. A machine directs radiation to the tumour and some of the surrounding tissue.

Radiation field

Radiation treatments are given to different areas of the body when treating HL. The radiation field is the part of the body that receives the radiation. Some of radiation fields to treat HL are:

  • involved field – only the lymph node areas with HL (the standard field used in combination with chemotherapy)
    • Chemotherapy is given first, followed by involved field radiation to the original site of the disease.
  • mantle field – lymph nodes in the neck, chest and armpits
  • upper abdominal field – lymph nodes in the upper abdomen and possibly the spleen
  • pelvic field, or inverted (upside down) Y field – lymph nodes in the pelvis and groin
  • extended field – the mantle field and uppermost part of the inverted Y field
    • This is seldom used anymore because nearly all people with HL are treated with chemotherapy.

Total nodal irradiation is the term used when radiation is given to all fields. It is basically a combination of the mantle and inverted Y fields. This approach may be used for people with widespread, advanced stage disease.

Total body irradiation is the term used when low-dose radiation is given to the entire body in preparation for a stem cell transplant.

Each person’s situation is unique, and the radiation fields may be adjusted depending on the extent of the disease.

See a list of questions to ask your doctor about radiation therapy.

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