NCCN Guidelines for Patients® | Diffuse Large B-cell Lymphoma
32 NCCN Guidelines for Patients ® : Diffuse Large B-cell Lymphoma, 2017 3 Overview of cancer treatments Radiation therapy Treatment sessions 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. 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 ( three - d imensional c onformal r adiation t herapy) delivers, from different angles, a photon beam that matches the shape of the target. IMRT ( i ntensity- m odulated r adiation t herapy) is a form of 3D-CRT. It further modifies the beam’s intensity during treatment. Proton therapy 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 the machine that delivers the radiation to also take images of the tumor and normal body structures. This can be done 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 Side effects from radiation therapy differ among people. Factors like treatment site, radiation dose, and length of treatment play a role. Side effects are cumulative. This means they build up slowly and are worse at the end of treatment. Your doctor will check on you every week during treatment. He or she will review skin care, medicines, and other options to help you feel better. Acute effects Acute effects are those that happen during treatment or shortly after the last session. 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, and feel painful when touched. You may also have short-term hair loss, but only where treated. Treatment to the head and neck can cause mouth sores, dry mouth, changes in taste, and a sore throat. Chest radiation can cause a dry cough or a sensation of a lump when you swallow. Radiation near your belly can cause nausea and maybe vomiting, and when given between your hip bones, diarrhea and cramps. Late effects Late effects are those that happen after treatment. Some do not go away. The effects depend on the treatment site. Examples include dry mouth, dental cavities, hypothyroidism, lung scarring, heart disease, infertility, and second cancers. Not all side effects of radiation are listed here. Please ask your treatment team for a complete list of common and rare side effects. If a side effect bothers you, tell your treatment team. There may be ways to help you feel better. There are also ways to prevent some side effects.