TY - JOUR

T1 - Modern Radiation Therapy for Nodal Non-Hodgkin Lymphoma—Target Definition and Dose Guidelines From the International Lymphoma Radiation Oncology Group

AU - Illidge, Tim

AU - Specht, Lena

AU - Yahalom, Joachim

AU - Aleman, Berthe

AU - Berthelsen, Anne Kiil

AU - Constine, Louis

AU - Dabaja, Bouthaina

AU - Dharmarajan, Kavita

AU - Ng, Andrea

AU - Ricardi, Umberto

AU - Wirth, Andrew

AU - International Lymphoma Radiation Oncology Group

N1 - Copyright © 2014 Elsevier Inc. All rights reserved.

PY - 2014

Y1 - 2014

N2 - Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.

AB - Radiation therapy (RT) is the most effective single modality for local control of non-Hodgkin lymphoma (NHL) and is an important component of therapy for many patients. Many of the historic concepts of dose and volume have recently been challenged by the advent of modern imaging and RT planning tools. The International Lymphoma Radiation Oncology Group (ILROG) has developed these guidelines after multinational meetings and analysis of available evidence. The guidelines represent an agreed consensus view of the ILROG steering committee on the use of RT in NHL in the modern era. The roles of reduced volume and reduced doses are addressed, integrating modern imaging with 3-dimensional planning and advanced techniques of RT delivery. In the modern era, in which combined-modality treatment with systemic therapy is appropriate, the previously applied extended-field and involved-field RT techniques that targeted nodal regions have now been replaced by limiting the RT to smaller volumes based solely on detectable nodal involvement at presentation. A new concept, involved-site RT, defines the clinical target volume. For indolent NHL, often treated with RT alone, larger fields should be considered. Newer treatment techniques, including intensity modulated RT, breath holding, image guided RT, and 4-dimensional imaging, should be implemented, and their use is expected to decrease significantly the risk for normal tissue damage while still achieving the primary goal of local tumor control.

KW - Adult

KW - Combined Modality Therapy

KW - Humans

KW - Lymphatic Irradiation

KW - Lymphoma, Non-Hodgkin

KW - Organs at Risk

KW - Radiotherapy Dosage

KW - Radiotherapy Planning, Computer-Assisted

KW - Tumor Burden

U2 - 10.1016/j.ijrobp.2014.01.006

DO - 10.1016/j.ijrobp.2014.01.006

M3 - Journal article

C2 - 24725689

VL - 89

SP - 49

EP - 58

JO - International Journal of Radiation Oncology, Biology, Physics

JF - International Journal of Radiation Oncology, Biology, Physics

SN - 0360-3016

IS - 1

ER -