Specht Lena
From the Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Cancer J. 2018 Sep/Oct;24(5):237-243. doi: 10.1097/PPO.0000000000000332.
Radiation therapy (RT) for Hodgkin lymphoma has changed dramatically over the past couple of decades, from the very large extended-field RT with prophylactic treatment of all the major lymph node regions to the very limited involved-site RT with treatment only of the initially macroscopically involved lymphoma volume in the combined modality setting. Technological developments in imaging, treatment planning, and treatment machines have enabled very significant reductions in radiation doses to normal organs without jeopardizing the coverage of the lymphoma. Hence, the risks of long-term adverse effects have become much smaller than those in the past. Radiation therapy for Hodgkin lymphoma is now a highly individualized treatment, tailored to each patient. The risks of this limited RT should be weighed against the risks of long-term toxicity of possible additional systemic treatment up-front and at relapse in order to select the optimal treatment combination for each individual patient.
在过去几十年里，霍奇金淋巴瘤的放射治疗（RT）发生了巨大变化，从对所有主要淋巴结区域进行预防性治疗的非常大的扩大野放疗，转变为在综合治疗模式下仅对最初肉眼可见受累的淋巴瘤体积进行治疗的非常有限的受累部位放疗。成像、治疗计划和治疗机器方面的技术发展，使得在不影响淋巴瘤覆盖范围的情况下，显著降低了对正常器官的辐射剂量。因此，长期不良反应的风险已比过去小得多。现在，霍奇金淋巴瘤的放射治疗是一种高度个体化的治疗方法，针对每个患者量身定制。这种有限放疗的风险应与前期及复发时可能的额外全身治疗的长期毒性风险进行权衡，以便为每个患者选择最佳的治疗组合。
