Palliative splenic irradiation for symptomatic splenomegaly in non-Hodgkin lymphoma

Ecancermedicalscience
Liliana Castro OliveiraPaulo Costa

Abstract

Splenic marginal zone lymphoma, an uncommon subtype of non-Hodgkin lymphoma (NHL), is usually present with symptomatic splenomegaly. Although splenectomy has long been considered the first-line therapy in symptomatic or cytopenic patients, it can lead to significant morbidity and mortality. Splenic irradiation is an option for patients who have a poor response to systemic therapy and/or are not surgical candidates. In this paper, we present a case report of a patient who received splenic radiotherapy for symptomatic splenomegaly. An 85-year-old Caucasian man with a 4 year history of low-grade NHL presented with progressive pancytopenia, significant weight loss and symptomatic splenomegaly (abdominal discomfort, sense of fullness and limitation of mobility due to spleen size). The patient refused splenectomy and, in December 2017, was referred to palliative splenic radiotherapy. He was initially treated with five fractions of one Grey (Gy) in order to evaluate clinical and haematology response. After that, 1.5 Gy daily, 5 days a week for 3 weeks. 3D conformal radiotherapy, multiple fields and mixed energy (6 and 15 Mv) were used. Radiotherapy allowed significant splenic reduction to almost half the size, resolving abdominal disc...Continue Reading

Citations

Mar 12, 2020·Case Reports in Surgery·David J HallChristiana M Shaw
May 28, 2020·Frontiers in Oncology·Jacob E RobinsonChristine E Cutucache

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