From the Department of Radiation Oncology.
Lymphoma Disease Management Team Memorial Sloan Kettering Cancer Center, New York, NY.
Cancer J. 2020 May/Jun;26(3):217-230. doi: 10.1097/PPO.0000000000000453.
Radiotherapy (RT) plays a diverse and essential role in the contemporary management of non-Hodgkin lymphoma (NHL) and remains the single most powerful monotherapeutic intervention for both aggressive and indolent subtypes. Over the past decade, there have been significant advancements in radiation oncology practice, which have made modern treatments safer and more conformal. Despite this sophistication and evidence supporting a continued role for RT, numerous data suggest that utilization is on the decline. In this review, we discuss the rationale for RT in 4 commonly encountered scenarios: combined modality therapy for limited-stage aggressive NHL, consolidation therapy for advanced-stage aggressive NHL, and the changing roles of salvage RT for relapsed/refractory NHL in an era of new frontiers such as cellular therapies. We also evaluate current strategies to treat indolent histologies. We conclude with perspectives on how RT for the hematological malignancies may continue to evolve.
放射治疗(RT)在非霍奇金淋巴瘤(NHL)的当代治疗中发挥着多样化且至关重要的作用,仍然是侵袭性和惰性亚型的单一最强大的单一治疗干预措施。在过去的十年中,放射肿瘤学实践取得了重大进展,这使得现代治疗更加安全和更具适形性。尽管如此复杂,并且有证据支持 RT 的持续作用,但许多数据表明其使用率正在下降。在这篇综述中,我们讨论了 RT 在以下 4 种常见情况下的基本原理:局限性侵袭性 NHL 的联合治疗模式、晚期侵袭性 NHL 的巩固治疗、以及在细胞治疗等新前沿时代,复发/难治性 NHL 的挽救性 RT 作用的变化。我们还评估了治疗惰性组织学的当前策略。我们最后讨论了血液恶性肿瘤的 RT 如何继续发展的观点。