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27

NCCN Guidelines for Patients

®

Hodgkin Lymphoma, Version 1.2015

Radiation therapy

Radiation therapy is often used with other treatments

but sometimes is used alone to treat Hodgkin

lymphoma. It consists of high-energy rays that

damage DNA. This either kills the cancer cells or

stops new cancer cells from being made. Radiation

can also harm normal cells. As a result, treatment

methods are always being improved to target the

tumor more precisely.

Involved-site radiation therapy

ISRT (

i

nvolved-

s

ite

r

adiation

t

herapy) is

recommended to treat Hodgkin lymphoma. It treats

the lymph nodes in which the cancer first started and

cancer near to these nodes. It is given with a method

called EBRT (

e

xternal

b

eam

r

adiation

t

herapy). This

method delivers radiation with a machine that is

outside your body.

Most times, treatment planning with a simulation

session is needed. During simulation, pictures of

the tumor will be taken after your body is moved into

the position needed for treatment. CT with contrast

is used. PET/CT and MRI (

m

agnetic

r

esonance

i

maging) often enhance treatment planning.

For tumors near your breastbone, 4D-CT (

f

our-

d

imensional

c

omputed

t

omography) can account for

tumor movement from breathing. If your breathing

causes large movements, motion control methods

during the scans may be used.

Using the scans, your treatment team will plan the

best radiation dose, number and shape of radiation

beams, and number of treatment sessions. Beams

are shaped with computer software and hardware

added to the radiation machine. Radiation beams are

aimed at the tumor with help from ink marks on your

skin.

During treatment, you will lie on a table in the same

position as done for simulation. Devices may be

used to keep you from moving. These may include a

mesh mask and body mold. You will be alone while

the therapists operate the machine from the nearby

control room.

The therapists will be able to see, hear, and speak

with you. As treatment is given, you may hear noises.

One session takes less than 10 minutes. The types of

EBRT include:

• 3D-CRT (

t

hree-

d

imensional

c

onformal

r

adiation

t

herapy) – Treatment is completed

in about 6 weeks and uses photon beams that

match the shape of the tumor,

• IMRT (

i

ntensity-

m

odulated

r

adiation

t

herapy)

– Treatment is completed in about 6 weeks

and uses photon beams of different strengths

based on the thickness of the tumor,

• Hadron (or proton) therapy – Treatment is

completed in about 6 weeks and uses proton

beams that deliver radiation mostly within the

tumor,

IGRT (

i

mage-

g

uided

r

adiation

t

herapy) can improve

how well the radiation beam targets some tumors.

IGRT uses a machine that delivers radiation and

also takes images of the tumor and normal body

structures. Images can be seen right before or during

treatment. These images are compared to the ones

taken during simulation. If needed, changes will be

made to your body position or the radiation beams.

Side effects of radiation

Most side effects of radiation depend on where the

treatment was given. However, many people feel

fatigue. Changes in skin are also common right after

treatment. Your treated skin may look and feel as if

it has a mild sunburn. It may also become dry, sore,

3

Overview of cancer treatments Radiation therapy