Depending on your type of lymphoma and whether or where it has spread, your doctor may use radiation therapy, alone or in combination with chemotherapy. In some cases, a radioactive atom is combined with an antibody that targets cancer cells and concentrates radiation at the site of the cancer.
External-Beam Radiation for Non-Hodgkin’s Lymphoma
Radiation therapy uses high-energy particles or beams, such as X-rays, to kill cancer cells and reduce the size of tumors. In external-beam radiation therapy, a machine outside the body delivers a dose of radiation that travels through the outer structures, such as the skin and the skeletal muscles, into deeper areas of the body.
For non-Hodgkin’s lymphoma, doctors most commonly use radiation to treat cancer in the spleen or in the lymph nodes in the mantle area (neck, chest, and armpits) or the groin.
We will tailor your radiation regimen to your specific situation. Typically patients with lymphoma who need external-beam radiation get one treatment each day, five days a week, for one to several weeks. External-beam radiation therapy is provided at all Seattle Cancer Care Alliance (SCCA) radiation oncology clinics.
Radioimmunotherapy for Non-Hodgkin’s Lymphoma
Radioimmunotherapy is a technique developed at SCCA over the last 20 years. A radioactive atom is attached to an antibody—like rituximab (Rituxan)—that targets specific cells, thereby limiting the amount of radiation to the body. Pioneering work in the 1990s by SCCA doctors Oliver W. Press, MD, PhD, and Frederick R. Appelbaum, MD, among others, led to the development of two radioimmunotherapy drugs approved by the U.S. Food and Drug Administration, ibritumomab tiuxetan (Zevalin) and the combination tositumomab and I-131 tositumomab (Bexxar).
Radioimmunotherapy is used primarily for B-cell lymphomas. SCCA patients receive this treatment at the SCCA clinic on south Lake Union. These medicines are usually given through an intravenous (IV) line into a vein in the hand or arm or through a port into a vein in the chest. Only a couple of treatments are required over the course of a week. Radioimmunotherapy works gradually, and your doctor will monitor the effect of the treatment with physical exams and imaging studies. It is usually not combined with other treatments, except to condition a patient for stem cell or bone marrow transplant.
Normal cells that are near your cancer may be affected by external-beam radiation, which can lead to side effects. The side effects vary greatly from person to person and depend on the type and dose of the radiation and the area of the body being treated.
In radioimmunotherapy using rituximab, the antibodies deliver radiation to both cancerous and normal lymphocytes (white blood cells) but spare other areas of the body. Over time, the body forms new lymphocytes. Overall, radioimmunotherapy is usually well tolerated.
Your treatment team can tell you about the side effects that are most common with your therapy. Let your team know about any side effects you experience.
For general information to help you cope with side effects, visit our section on symptom management.