Best Practice & Research Clinical Gastroenterology
Volume 24, Issue 1 , Pages 27-34, February 2010

Role of radiotherapy in the treatment of lymphomas of the gastrointestinal tract

  • Berthe M.P. Aleman, MD, PhD (Radiation Oncologist (Staff Position) at Specialised Cancer Institute)

      Affiliations

    • Department of Radiotherapy, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
    • Corresponding Author InformationCorresponding author. Tel.: +31 205122124; fax: +31 206691101.
    • ,
  • Rick L.M. Haas, MD, PhD (Radiation Oncologist (Staff Position) at Specialised Cancer Institute)

      Affiliations

    • Department of Radiotherapy, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
    • ,
  • Richard W.M. van der Maazen, MD, PhD (Radiation Oncologist (Staff Position) at University Hospital)

      Affiliations

    • Department of Radiotherapy, Radboud University, Nijmegen Medical Centre, Geert Grooteplein 10, 6500 HB Nijmegen, The Netherlands
    • Tel.: +31 243614515; fax: +31 243568350.

In patients with gastrointestinal lymphoma the most frequently involved site is the stomach (60%–75% of cases), followed by the small bowel, ileum, cecum, colon and rectum. The most common histological subtypes are extranodal marginal zone B-cell lymphoma of the mucosa-associated lymphoid tissue (MALT) and diffuse large B-cell lymphoma (DLBCL). The role of radiotherapy is most definite in early stage gastric lymphoma.

The therapeutic approach for patients with gastric Non Hodgkin lymphoma (NHL) has changed significantly over the last decades. The primary treatment of limited gastric MALT lymphoma consists of Helicobacter pylori eradication. In case of insufficient response to H. pylori eradication or in case H. pylori is absent, irradiation of the stomach and perigastric lymph nodes to a dose of 30–40Gy in 15–20 fractions is indicated. In patients with gastric DLBCL conservative treatment with anthracycline-based chemotherapy alone or in combination with involved-field radiotherapy has become the therapy of choice.

Key words: Radiotherapy, Gastrointestinal lymphoma, Gastric MALT lymphoma

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PII: S1521-6918(09)00155-3

doi:10.1016/j.bpg.2009.12.002

Best Practice & Research Clinical Gastroenterology
Volume 24, Issue 1 , Pages 27-34, February 2010

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