Application of radiotherapy and chemotherapy in the treatment of Hodgkin's lymphoma

Radiotherapy and chemotherapy are the two main methods for treating Hodgkin's lymphoma. Combining the two can help enhance clinical efficacy.

ABVD is the preferred chemotherapy regimen at present. Chemotherapy drugs mainly include doxorubicin, bleomycin, vinblastine and dacarbazine. The combined application of ABVD and radiotherapy in clinical practice is mainly based on the clinical stage of the tumor.

(1) Patients with stage IA-IIA non-bulky Hodgkin lymphoma are first treated with ABVD regimen for 4 courses, followed by local radiotherapy (20-30 Gy) to the affected field after remission, or radiotherapy alone.

(2) Patients with stage IA-IIA bulky disease are usually treated with ABVD regimen for 4-6 courses, followed by local radiotherapy after remission. Radiotherapy should include the mediastinum and bilateral supraclavicular regions. If the initial lesion in the affected field is >5 cm, 36 Gy should be irradiated.

(3) Patients with stage IB-IIB and stage III-IV and lymphocyte-depleted disease should be treated with ABVD regimen for 6-8 courses, followed by local radiotherapy after remission. The initial lesions in the affected field >5 cm and lesions in the spleen should be irradiated with 36 Gy.

(4) For patients with stage IA-IIA Hodgkin lymphoma with nodular lymphocyte predominance, affected field irradiation alone can be performed, and for stage III-IV, chemotherapy alone can be performed, or involved field irradiation after remission can be performed. In addition, the addition of rituximab to the treatment can improve the efficacy.

Tips: Rituximab

Rituximab is a monoclonal antibody that can bind to the surface of malignant B cells, thereby helping the body's immune system recognize and kill cancer cells.