A combination of radiation therapy and chemotherapy has proven to be an effective two-pronged approach to treating stages I and II Hodgkin lymphoma. Patients who have more widespread disease (stages III and IV and category B) are generally treated with chemotherapy alone.
Involved field radiation therapy with chemotherapy - also known as combined modality therapy - involves two major steps done at separate times, usually in an oncology clinic's outpatient center:
- Chemotherapy drugs are given to kill neighboring lymphoma cells.
- Radiation is delivered by high-energy rays to shrink masses of lymphoma cells.
You may need to remain in the hospital for a short period during treatment if your therapy is particularly intensive and leads to infection or prolonged or severe decreases in blood cell counts.
During involved field radiation therapy, you receive radiation only to the areas of your body affected by Hodgkin lymphoma. A machine called a linear accelerator, or linac, delivers beam radiation to targeted area(s) of your body while you lie on a moveable table. Parts of your body not affected by Hodgkin lymphoma, like the reproductive organs, are shielded to help reduce the treatment's side effects. The procedure itself is painless, though some people may feel uncomfortable remaining in the same position for several minutes during the session.
Several days later, your radiation therapy is followed up with chemotherapy.
Nodular Lymphocyte-Predominant Hodgkin Treatment
One exception to using the first-line combined treatment of radiation therapy and chemotherapy is treatment for the nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) subtype. Instead, radiation therapy is used alone and not combined with chemotherapy.
NLPHL is a slow-growing form of the disease that's usually diagnosed during stage I, resulting in a nearly 100 percent survival rate. Therefore, it's important to not overtreat the disease. In fact, experts suggest that chemotherapy can increase the risk of NLPHL returning.