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Radiation Therapy for Non-Hodgkin Lymphoma

Radiation therapy uses high-energy rays to kill cancer cells.

When might radiation therapy be used for non-Hodgkin lymphoma?

Radiation might be used to treat non-Hodgkin lymphoma (NHL) in some different situations:

  • It can be used as the main treatment for some types of NHL if they are found early (stage I or II).
  • For more advanced lymphomas and for some lymphomas that are more aggressive, radiation is sometimes used along with chemotherapy.
  • People who are getting a stem cell transplant may get radiation to the whole body along with high-dose chemotherapy, to try to kill lymphoma cells throughout the body.
  • Radiation therapy can be used to ease (palliate) symptoms caused by lymphoma that has spread to organs such as the brain or spinal cord, or when a tumor is causing pain because it’s pressing on nerves.

How is radiation therapy given?

When radiation is used to treat NHL, it’s most often done with a carefully focused beam of radiation, delivered from a machine outside the body. This is known as external beam radiation. External beam radiation treatment for NHL might include beams made of photons (most common), protons, or electrons depending on the situation.

Before your treatment starts, your radiation team will take careful measurements to find the correct angles for aiming the radiation beams and the proper dose of radiation. This planning session, called simulation, usually includes getting imaging tests such as CT or MRI scans.

Most often, radiation treatments are given 5 days a week for several weeks. The treatment is much like getting an x-ray, but the radiation is stronger. The procedure itself is painless. Each treatment lasts only a few minutes, although the setup time – getting you into place for treatment – usually takes longer.

Possible side effects

The side effects of radiation therapy depend on where the radiation is aimed.

Common side effects include:

  • Skin changes in areas getting radiation, ranging from redness to blistering and peeling
  • Feeling tired
  • Nausea
  • Diarrhea

Nausea and diarrhea are more common if the abdomen (belly) is treated with radiation.

Radiation given to several areas, especially after chemotherapy, can lower blood cell counts and increase the risk of infections.

Radiation to the head and neck area can lead to mouth sores and trouble swallowing. Some people later have problems with dry mouth.

Often these effects go away shortly after treatment is finished.

Side effects tend to be worse if radiation and chemotherapy are given together.

Long-term serious side effects are possible:

  • Radiation to the chest might damage the lungs and lead to trouble breathing. It can also affect the heart, and it may increase the chance of a heart attack later on.
  • Radiation to the neck can lead to thyroid problems later in life. This can lead to fatigue and weight gain.
  • Side effects of brain radiation therapy may become serious about 1 or 2 years after treatment and may include headaches and problems, such as memory loss, personality changes, and trouble concentrating.
  • Other types of cancer can form in the area that received radiation. For example, radiation to the chest may increase the risk of lung cancer (especially in people who smoke) and of breast cancer, but this is rare.

More information about radiation therapy

To learn more about how radiation is used to treat cancer, see Radiation Therapy.

To learn about some of the side effects listed here and how to manage them, see Managing Cancer-related Side Effects.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Conger RL, Mora J, Straza MW, et al. Evolution in the presence & evidence category of radiation therapy treatment recommendations in the national comprehensive cancer network (NCCN) clinical practice guidelines in oncology. Adv Rad Onc. 2023:101206.

Freedman AS, Aster JC. Clinical manifestations, pathologic features, and diagnosis of extranodal marginal zone lymphoma of mucosa associated lymphoid tissue (MALT). In Post TW, ed. UpToDate. UpToDate, 2022.

National Cancer Institute. Physician Data Query (PDQ). Adult Non-Hodgkin Lymphoma Treatment. 2023. Accessed at https://www.cancer.gov/types/lymphoma/patient/adult-nhl-treatment-pdq#_190 on September 29, 2023.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: B-Cell Lymphomas. Version 6.2023. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/b-cell.pdf on November 30, 2023.

National Comprehensive Cancer Network (NCCN). Practice Guidelines in Oncology: T-Cell Lymphomas. Version 1.2023. Accessed at https://www.nccn.org/professionals/physician_gls/pdf/t-cell.pdf on November 30, 2023.

Last Revised: February 15, 2024

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