RADIATION THERAPY OF GENERALIZED LYMPHOCYTIC LYMPHOMAS

The overwhelming majority of patients with malignant lymphomas of the lymphocytic type present with generalized disease at the time of diagnosis. The consequent need for systemic therapy has resulted in the adoption of chemotherapy as the accepted form of treatment.

As an alternative, we have investigated "systemic radiotherapy" utilizing total body irradiation and other wide-field techniques.

The experience described in this report concerns a consecutive series of patients with generalized lymph node involvement on admission. Cases with documented lymphomatous invasion of the bone marrow are included, while those with involvement of other extranodal sites have been excluded from this review.

The complete remission rate was 93 per cent (27 of 29 patients) and the median duration of remission without maintenance therapy was 26 months.

Following relapse, irradiation was again employed effectively in most instances.

Response to therapy was not related to the histologic degree of tumor cell differentiation and was not affected by the presence of bone marrow involvement.

A 3 year survival rate of 86 per cent demonstrates the potentially important role for radiation therapy despite the existence of anatomically widespread involvement.

It must be recognized, however, that the radiotherapy approach should be comprehensive and aimed at control of the entire systemic process rather than limited to the palliation of symptomatic regions.

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