How Effective is Radiation Treatment for Non-Hodgkin Lymphoma?

One area where radiation is especially effective is in consolidation therapy. This is when you get radiation after other treatments, to try to get rid of any cancer cells that might still remain in your body.

For example, people with diffuse large B-cell lymphoma are often first treated with a drug cocktail known as R-CHOP. It’s a combination of the monoclonal antibody rituximab (Rituxan), along with three chemotherapy drugs and the steroid prednisone.

Even when lymphoma goes into remission on R-CHOP, the cancer can sometimes come back. Giving radiation afterward helps prevent it from returning. Radiation works particularly well in people with early-stage non-Hodgkin lymphoma. “For patients with stage I and stage II disease, the outcomes are excellent, approaching 90%,” Dr. Pannix says.

For people with later stage lymphoma, usually radiation will only be used to treat areas with larger tumors — what doctors call “bulky disease.” While there is a higher risk of relapse outside the radiation field, for local control radiation is also very effective in this scenario. After delivering the radiation, the chance that the cancer will stay away in that particular area is very high — between 80% to 90% or more, Dr. Pannix adds.

Delivering a More Precise Beam of Radiation

When doctors aim radiation at your body, there’s always the risk that these strong rays could damage some of the healthy tissue surrounding your cancer. That damage is what leads to side effects such as red or blistered skin, mouth sores, nausea, and vomiting.

In the past, doctors delivered radiation in a wide beam to the general area of the cancer. Today it’s possible to administer radiation more precisely to the tumor. It’s a technique called intensity-modulated radiation therapy, or IMRT.

First, doctors use imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI) to map out the exact shape of the tumor. Then, a computer calculates the precise dose of radiation needed to treat it.

The computer calculations mold the beam of radiation to the exact three-dimensional shape of the tumor. Because the beam is more focused to the cancer, it can deliver a much higher dose of radiation without damaging the healthy tissues around the tumor.

Another new technique called volumetric modulated arc therapy, or VMAT, also targets radiation more specifically. In VMAT, the machine constantly rotates to shape the radiation to the tumor, while avoiding nearby tissues. This technique is especially useful when the cancer sits very close to other organs.

What to Expect

Before your treatment, your medical team will take measurements to determine the exact dose of radiation you’ll be getting, and where to deliver it. The preparation might include imaging tests such as MRI and CT scans to plot out the exact angles for the radiation.

You’ll get a series of radiation treatments several days in a row. Each treatment session lasts for just a few minutes and is painless. The duration of treatment will differ based on your stage of lymphoma and the extent of the disease.

Before you start your first radiation session, ask your doctor how radiation therapy is expected to help your cancer, and what side effects it might cause. You may be able to get treatments to help manage some of the side effects.

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