Radiation Therapy

A detailed description of various radiotherapy techniques is beyond the scope of this chapter. Briefly, when radiation therapy is used alone for limited stage HL, tumor doses of 150-200 cGy are generally given 5 days/week, with a total dose of 3,600-4,000 cGy delivered over approximately 5 weeks. "Boosts" of radiation therapy may be given to bulky disease sites. Given that limited stage HL is usually above the diaphram, the most common field incorporated is the mantle field. The mantle field encompasses the mediastinal, hilar, sub-carinal, axillary, infraclavicular, supraclavicular, cervical, and submandibular lymph nodes. The para-aortic field encompasses the para-aortic nodes to approximately the L5 vertebral body. Frequently, para-aortic radiation therapy also encompasses the splenic pedicle, where the spleen is still intact. The combination of mantle, para-aortic, and pelvic radiation therapy is known as total lymphoid irradiation; the para-aortic region and pelvic region is known as an inverted Y.

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