Radioterapia em linfomas não-Hodgkin

• Autor(a) principal: Faria, Sérgio Luiz
• Data de Publicação: 2023
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista Brasileira de Cancerologia (Online)
• Texto Completo: https://rbc.inca.gov.br/index.php/revista/article/view/3079
• topic: Linfomas Não-Hodgkin; Radioterapia; Non-Hodgkin’s Lymphomas; Radiation Therapy

The Non Hodgkin lymphomas (NHL), as all malignant lymphomas, are very responsive to radiation therapy (XRT). Doses of 3,500 to 4,500 cGy at standard fractionation of 900 to 1,000 cGy per week, wíth megavoltage photons, should provide local control with almost no damage to nelghbor normal tissue. However, most NHL Show advanced stage at first sight and that makes exclusive radiation a limited option of treatment to NHL. XRT in children have still more limited Indications because radiation may cause deformities in bone and muscles. Patients with NHL that can benefit from exclusive XRT are mostiy adults with low grade and localized tumors (stages I and some II), or with large cell lymphomas, stage I. More advanced cases and those with more agressive histologies neeá combined modality treatments or even just chemotherapy. Optim radiation management programs for the NHL require adequate equipment including simulator and megavoltage machines and that is many times difflcult in Brazil. It remains to be defined the exact extension of the fields and the ideal doses, particularly in combined treatments. Extended fields like the “mantie” field or “inverted Y" field have been used less frequently; involved fields that implies treatment limited to the involved lymphoid region has been more often utilized in combined treatments. Generally XRT has been used after chemotherapy, but some programs alternate both modalities. XRT has been indicated in prophylaxis of CNS in patients with high risk for CNS involvement but this issue has not been resolved yet.