Cancers of the lymph nodes, such as Hodgkin’s Disease or non-Hodgkin’s Lymphoma, can involve single or multiple lymph node regions, and occasionally other (extra-nodal) sites. Lymphocytes, a type of white blood cell, multiply at a fast rate, eventually growing to form a bulky tumor. Lymphomas may also develop in the spleen and bone marrow.

Lymphomas can be lethal if they migrate from the initially affected area to other parts of the body in the lymphatic system or through the blood. Effective diagnostic workup may discover visible evidence of disease or symptoms at locations distant from the original site.

For treatment of localized lymphomas, 3 to 4 weeks of irradiation alone often suffices for local control. When multiple anatomical sites are involved, irradiation is often used as supplementary treatment for bulky sites or to persistent disease following systemic chemotherapy. Tomotherapy can help limit radiation side effects to adjacent tissues, especially when treating lymphoma sites near vital structures, or in the head and neck region, or for extra-nodal sites such as the stomach.

Optimal treatment often involves chemotherapy, and radiation therapy is frequently used to treat involved or bulky sites, often using large fields of treatment to cover multiple lymph-node-bearing regions. Although the doses required for an excellent outcome are low and can usually be given in 3 to 4 weeks, sometimes large volumes of lung or small intestine can be at risk for damage. Tomotherapy can do a good job of limiting dosage to these normal structures, and by using CT image guidance, the uncertainty of reproducing treatment positioning for large fields of treatment can be reduced.

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