Radiation therapy for children with malignant lymphoma is normally limited to children with Hodgkin's lymphoma. Total body irradiation is sometimes necessary for patients as part of a stem cell transplantation in cases of relapse.
Radiation therapy is almost always given in combination with chemotherapy. The protocols give clear guidelines for use of radiation therapy and advice for anatomical areas suitable for radiation therapy including the volume of radiation to the tumor area, image diagnostics, dosage planning, radiation dosages, and limitations for use of radiation therapy.
Radiation therapy is an effective treatment form and can improve chances of disease-free long-term survival of Hodgkin's lymphoma. However, the risk for delayed side effects in children, especially growth disturbances, damage to the irradiated organ, and radiation-induced secondary cancer makes the use of radiation therapy strictly limited to situations where the benefit outweighs the risk.
The dosages are significantly lower and the risk for delayed damage is much less than in radiation therapy of most solid tumors and tumors of the central nervous system.
For children with non-Hodgkin lymphoma, radiation therapy is performed only for special indications. Radiation as part of the primary treatment only occurs when there is CNS infiltration of non-B non-Hodgkin lymphoma. Children > 5 years having CNS infiltration of non-B non-Hodgkin lymphoma are irradiated to the cranium with 18 Gy. The daily dosage is 1.5 Gy and is given in 5 fractions during the week until the total dosage is reached.
Radiation therapy for lymphoma is given at the university hospitals.