How are the radiation fields used to treat Hodgkin lymphoma (Hodgkin disease) defined?

Updated: Sep 12, 2018
  • Author: Bradley W Lash, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

The radiation fields used in the treatment of Hodgkin lymphoma have evolved to maximize response while minimizing toxicity. Although there are several definitions of radiation fields, the following are generally used:

  • Extended-field radiation (EFRT): Radiation that includes not only the clinically involved nodes but also the adjacent, clinically uninvolved nodes; this is called mantle-field or inverted-Y field; EFRT is not used in modern treatment of Hodgkin lymphoma

  • Involved-field radiation (IFRT): Radiation field that encompasses all of the clinically involved regions (eg, the mediastinum and the low-supraclavicular fields)

  • Involved-site radiation (ISRT): Radiation field that includes pre- and post-chemotherapy nodal volumes plus a 1.5-cm margin of healthy tissue

  • Involved-node radiation (INRT): Radiation field that includes pre- and post-chemotherapy nodal volumes plus a 1-cm margin of healthy tissue; there are increasing data to support this, but it is still considered experimental [48]

ISRT is largely replacing IFRT. Current NCCN and international guidelines recommend ISRT for Hodgkin lymphoma. [4, 49]


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