Low-dose Total Body Irradiation in the Treatment of Advanced Non-Hodgkin’s Lymphoma : A Case Report of an Elderly Patient
A 73-year-old man underwent six courses of chemotherapy with THP-COP and external beam radiotherapy for primary non- Hodgkin's lymphoma (NHL) in the neck. The treatment turned out well and the patient experienced a complete response. Two months later, magnetic resonance imaging revealed involvement in the mediastinal, axillary, para-aortic, and inguinal lymph nodes. The patient remained clinically free of the disease for another two months with oral etoposides and prednisolone, but then relapse occurred, which was treated by low-dose total body irradiation (LTBI). LTBI improved the health of the patient and resulted in the second complete remission. The patient subsequently underwent four courses of chemotherapy with CEOP and maintained his health without major toxicity for further three months. Finally, however, relapse occurred throughout the entire body, and the patient died of NHL 28 months after the initial presentation. This report supports the notion that the LTBI is effective in salvage treatment for NHL patients in high risk groups.