Radiation Therapy for Non-Hodgkin Lymphoma in Children

Radiation therapy uses high-energy rays to kill cancer cells. This was once a very common treatment for children with non-Hodgkin lymphoma (NHL). But as doctors have developed more effective chemotherapy treatments, radiation therapy has been used less.

How is radiation therapy given?

Radiation focused on a cancer from a source outside the body is called external beam radiation. This is the type of radiation therapy most often used to treat NHL.

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

The treatment itself is much like getting an x-ray, but the radiation is stronger. It is painless, but some younger children might still need to be sedated to help make sure they don’t move during the treatment. Each treatment lasts only a few minutes, although the setup time – getting your child into place for treatment – usually takes longer. The number of treatments will depend on the reason they're being given.

When would radiation therapy be used?

There are a few instances in which radiation therapy may be used.

  • Sometimes it is used along with chemotherapy. This might be done if the lymphoma has reached the brain or spinal cord.
  • It may be used as a form of urgent treatment in children with symptoms caused by large tumors in the chest.
  • It may be used as part of treatment for children who are getting high-dose chemotherapy and a stem cell transplant.
  • It can be used to relieve symptoms from lymphoma, such as pain from a tumor that's pressing on nerves.

Possible risks and side effects

Short-term side effects of radiation therapy depend on where it is aimed. For example:

  • It may cause sunburn-like skin problems or hair loss in the area being treated.
  • Radiation therapy that includes large parts of the body can cause fatigue.
  • Radiation to the abdomen (belly) can sometimes cause nausea, vomiting, or diarrhea.

Often these effects go away after a short while.

Possible long-term side effects of radiation therapy in children can be more serious, and may occur after many years.

  • Radiation therapy to the chest may damage the lungs or heart, which could raise the risk of lung or heart problems later in life. In the long term, radiation to the chest may also increase the risk of lung cancer (especially in smokers) and of breast cancer.
  • Radiation therapy to the brain might cause headaches and problems such as memory loss, personality changes, and trouble learning at school.
  • Radiation to other parts of the body may slow a child’s growth or increase the risks for certain other cancers, such as those of muscle or bone (called sarcomas) or of the digestive tract.

Because of these possible long-term effects, doctors try to avoid using radiation therapy in children or limit the doses used whenever possible. For more on possible long-term effects, see Late and Long-term Effects of Treatment for Non-Hodgkin Lymphoma in Children.

To learn more about this type of treatment, see Radiation Therapy.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master’s-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Allen CE, Kamdar KY, Bollard CM, Gross TG. Malignant non-Hodgkin lymphomas in children. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. 7th ed. Philadelphia Pa: Lippincott Williams & Wilkins; 2016:587–603.

Kamdar KY, Sandlund JT, Bollard CM. Malignant lymphomas in childhood. In: Hoffman R, Benz EJ, Silberstein LE, Heslop HE, Weitz JI, Anastasi J, eds. Hematology: Basic Principles and Practice. 6th ed. Philadelphia, Pa: Elsevier; 2013:1255−1266.

National Cancer Institute Physician Data Query (PDQ). Childhood Non-Hodgkin Lymphoma Treatment. 2016. Accessed at www.cancer.gov/types/lymphoma/hp/child-nhl-treatment-pdq on June 8, 2017.

Rabin KR, Margolin JF, Kamdar KY, Poplack DG. Leukemias and lymphomas of childhood. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 10th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2015:1500–1510.

Sandlund JT, Onciu M. Childhood lymphoma. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 5th ed. Philadelphia, Pa: Elsevier; 2014:1873–1889.

Last Medical Review: June 20, 2017 Last Revised: August 4, 2017

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.