Times Not to Forget Radiotherapy When Treating Patients With Lymphoma

Charles A. Enke, MD


J Oncol Pract. 2019;15(4):167-172. 

In This Article

Gastric Malt Lymphoma

Gastric MALT lymphoma presentations (either Helicobacter pylori negative at presentation or failed to respond to antibiotic therapy when H pylori was present at diagnosis) are candidates for definitive radiation therapy. The presence of a chromosomal translocation t(11;18) associated with gastric MALT lymphoma indicates a high probability of failure to respond to antibiotic therapy, and upfront use of radiation therapy should be strongly considered.[16] Usually these lymphomas present with stage I disease with rare perigastric nodal involvement. Radiation therapy is typically given at 1.5 Gy per fraction to a total dose of 30 Gy. The response rate is 95%, and the local failure rate is less than 10%.[16] I simulate and treat patients in a fasting state, usually early in the treatment day. The entire stomach is treated with adequate margin to allow for gastric volume changes. Image-guided radiation therapy is important for daily targeting.