Overview
Extranodal lymphomas (ENLs) represent approximately one-third of all non-Hodgkin lymphomas (NHL), occurring in various organs throughout the body with diverse histological subtypes 1.Diagnosis
Imaging studies (CT, MRI) to identify extranodal involvement 1.
Biopsy confirmation of lymphoma subtype 1.
Laboratory tests including CBC, LDH, and other biomarkers for staging 1.Management
First-line treatment: Radiation therapy (RT) is common, especially for indolent ENL subtypes 1.
Adjunctive treatments: Systemic chemotherapy, targeted therapies, or immunotherapy post-RT consolidation or salvage 1.
Specific RT approaches: Involved-site radiation therapy (ISRT) principles applied, tailored to organ-specific challenges 1.Special Populations
Elderly: Considerations for dose and volume adjustments in elderly patients due to comorbidities and tolerance 1.
Comorbidities: Tailored RT planning to minimize impact on functioning organs affected by comorbidities 1.Key Recommendations
Apply involved-site radiation therapy principles for defining treatment volumes in extranodal lymphomas to minimize exposure and maximize efficacy (Evidence: Expert opinion) 1.
Tailor radiation therapy planning based on the specific organ involved to address technical challenges in simulation and volume definition (Evidence: Expert opinion) 1.
Use radiation therapy as a primary or consolidative treatment modality, particularly for indolent extranodal lymphomas, considering individual patient factors (Evidence: Expert opinion) 1.References
1 Yahalom J, Illidge T, Specht L, Hoppe RT, Li YX, Tsang R et al.. Modern radiation therapy for extranodal lymphomas: field and dose guidelines from the International Lymphoma Radiation Oncology Group. International journal of radiation oncology, biology, physics 2015. link