Radiation Therapy for Lymphoma in Children

Radiation therapy uses high-energy x-rays or particles to kill cancer cells. Today, radiation is not often needed to treat lymphoma. However, it can be useful in certain situations.

Radiation therapy for Hodgkin lymphoma

Hodgkin lymphoma (HL) responds well to radiation therapy, but radiation can cause health problems after treatment ends. As Hodgkin lymphoma treatments have improved, doctors have tried to reduce the amount of radiation children and teens get and remove radiation from treatment plans when possible. However, radiation might still be recommended in some cases.

Radiation might be used as a part of initial treatment for HL if:

• The child or teen has very large lymph nodes in their chest at diagnosis
• Involved lymph nodes are slow to respond to chemo treatments
• Lymph nodes are still enlarged or show up on a PET scan after a few cycles of chemo

Radiation might also be recommended if HL doesn’t respond well to initial treatment or if it comes back after treatment.

Radiation therapy for non-Hodgkin lymphoma

Like Hodgkin lymphoma, doctors avoid using radiation to treat non-Hodgkin lymphoma (NHL) when possible, because radiation can cause health problems after treatment ends.

As treatments have improved, doctors have tried to reduce the amount of radiation and remove radiation from treatment plans when possible.

Radiation might be used in some cases, including:

• When the lymphoma has reached the brain or spinal cord
• If a child or teen needs urgent treatment because of symptoms caused by large tumors in their chest
• As part of treatment for children who are getting a stem cell transplant
• To relieve symptoms from lymphoma, such as pain from a tumor pressing on nerves

How is radiation therapy given?

This type of treatment is given by a doctor called a radiation oncologist.

Before treatments start, the radiation team takes careful measurements with imaging tests such as CT or MRI. This is done during a planning session called a treatment simulation.

The treatment itself is like getting an x-ray, but the radiation is much stronger.

Each treatment lasts only a few minutes. The entire session takes about 15 to 30 minutes, but most of this time is spent making sure the radiation is aimed correctly. The treatment is painless, but some younger children may need to take medicine beforehand so they don’t move during the treatment.

Possible side effects of radiation

The side effects of radiation therapy depend on the dose of radiation and where in the body it is given.

Short-term side effects can happen during or shortly after treatment, including:

• Fatigue
• Hair loss in the treated area
• Red, tender, or dry skin in the treated area, similar to a sunburn
• Low blood counts
• Mouth sores, trouble swallowing, or loss of appetite from radiation to the head and neck area
• Nausea, vomiting, cramps, and/or diarrhea from radiation to the belly

Radiation can also have long-term side effects. These are described in After Treatment for Lymphoma in Children.