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ICML 2025 | The current use of radiotherapy in lymphoma & how its role has evolved in recent years
Lena Specht, MD, University of Copenhagen, Copenhagen, Denmark, shares insights into the evolution of radiotherapy’s role in treating lymphomas, noting that while it was once the primary curative modality, its use has shifted to consolidation after systemic treatment, except for some early-stage patients with localized disease. This interview took place during the 18th International Conference on Malignant Lymphoma (18-ICML) in Lugano, Switzerland.
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Transcript
Well, radiotherapy used to be the only curative modality for lymphomas, but its role has changed because a lot of systemic treatments have appeared. So now it’s usually used as a consolidation after the use of systemic treatment. Although for some early stage patients with localized disease, for instance, indolent lymphomas and the nodal lymphocyte predominant Hodgkin lymphoma, radiotherapy is actually the primary definitive treatment but in most cases it’s as a consolidation after some systemic treatment...
Well, radiotherapy used to be the only curative modality for lymphomas, but its role has changed because a lot of systemic treatments have appeared. So now it’s usually used as a consolidation after the use of systemic treatment. Although for some early stage patients with localized disease, for instance, indolent lymphomas and the nodal lymphocyte predominant Hodgkin lymphoma, radiotherapy is actually the primary definitive treatment but in most cases it’s as a consolidation after some systemic treatment. Well the changes of the use has been very much influenced by there’s been a fear of long-term complications from radiation therapy that stems from a time when we irradiated well total lymphoid irradiation all lymph nodes in the body which of course irradiated kilos of normal tissue which gave rise to serious long-term complications but we have now implemented and used to the best advantage the modern highly conformal highly sophisticated radiation techniques and we have done research demonstrating that the radiosensitivity of lymphomas is very high and very varied among the different lymphoma types so that we’ve been able to reduce the doses and we have reduced the volumes we are irradiating very dramatically, which again of course results in far less risk of long-term complications. In many cases, we’ve been able to reduce the risks to a level where it cannot be detected statistically. That’s a greater treatment I think and it’s been highly helped by the fact that we created a worldwide organization called the International Lymphoma Radiation Oncology Group we created it about almost 15 years ago it’s now a worldwide organization with 1500 members around the world and we are doing research and teaching and guidelines and so on and have in that way we have been able to spread the message of modern radiation therapy for lymphomas to the rest of the world.
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