The Effects of Radiation Therapy on Patients with Diffuse Large B-cell lymphoma

Dorth Kelsey^*
*Correspondence: Dorth Kelsey, Department of Radiation Oncology, Duke University Medical Center, 3085, Durham, NC 27710, USA, Email:

Keywords

Antibodies • Cancer • Diagnosis

Introduction

The exact causes of DLBCL are not fully understood, but certain factors have been associated with an increased risk of developing the disease. These include a weakened immune system, such as in people with HIV or those who have undergone an organ transplant, exposure to certain chemicals or radiation and genetic factors. Diagnosis of DLBCL typically involves a combination of imaging tests, such as CT or PET scans and biopsy of affected tissue to confirm the presence of cancer cells. Once diagnosed, staging of the cancer is performed to determine the extent of the disease and to guide treatment. Treatment of DLBCL usually involves a combination of chemotherapy and immunotherapy, which are drugs that target and kill cancer cells or enhance the body's immune response to fight cancer. In some cases, radiation therapy may also be used. The specific treatment plan will depend on the stage and extent of the cancer, as well as the patient's overall health and other medical factors.

Prognosis for DLBCL can vary widely depending on several factors, including the stage and extent of the cancer, the patient's age and overall health and the response to treatment. Overall, however, the prognosis for DLBCL has improved significantly over the past few decades with the development of new and more effective treatments. DLBCL is a common and aggressive type of non-Hodgkin's lymphoma that can develop anywhere in the body. Early diagnosis and prompt treatment are essential for improving outcomes and increasing the chances of a full recovery. Anyone experiencing persistent symptoms should consult their healthcare provider for further evaluation and testing.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin's lymphoma, a cancer that affects the body's lymphatic system. While chemotherapy is often the first line of treatment for DLBCL, radiation therapy may also be used in some cases to target residual disease that remains after chemotherapy. However, determining the efficacy of radiation therapy in these cases can be challenging. A recent study aimed to evaluate the impact of radiation therapy on patients with DLBCL who have positive postchemotherapy fluorodeoxyglucose-positron emission tomography (FDG-PET) or gallium-67 scans. FDG-PET and gallium-67 scans are imaging tests that can detect cancerous tissue in the body. A positive scan indicates that there is active cancer present in the body, even after chemotherapy.

Literature Review

A gallium scan, also known as a gallium-67 scan or a gallium citrate scan, is a medical imaging test that uses a small amount of radioactive material to help diagnose and monitor certain conditions in the body. This test is typically performed by a nuclear medicine technologist and interpreted by a radiologist or other medical specialist. The radioactive material used in a gallium scan is gallium-67 citrate, a substance that is injected into a vein in the arm. The gallium-67 travels through the bloodstream and accumulates in areas of the body that are actively producing white blood cells, such as bone marrow, lymph nodes and areas of inflammation or infection. After the gallium-67 has had time to accumulate in these areas, the patient is placed under a special camera that detects the radioactive emissions from the gallium-67. This information is then processed by a computer to produce detailed images of the areas of the body where the gallium-67 has accumulated. Gallium scans are most commonly used to diagnose and monitor certain types of cancer, such as lymphoma, as well as to detect and monitor certain infections, such as tuberculosis or fungal infections. They can also be used to monitor the effectiveness of treatment for these conditions, as areas of the body where the gallium-67 has accumulated will typically decrease in size and intensity with successful treatment.

One advantage of a gallium scan is that it can detect areas of the body where cancer or infection may be present before they are visible on other imaging tests, such as X-rays or CT scans. This can help healthcare providers to diagnose these conditions at an earlier stage and provide more effective treatment. However, there are some risks associated with a gallium scan, as with any medical imaging test that involves radiation exposure. The amount of radiation exposure from a gallium scan is typically low, but patients who are pregnant or breastfeeding should discuss the risks and benefits of the test with their healthcare provider before undergoing the procedure. Overall, a gallium scan is a safe and effective imaging test that can provide valuable information to healthcare providers about the presence and extent of certain conditions in the body. Patients who are scheduled to undergo a gallium scan should discuss the procedure in detail with their healthcare provider and ask any questions they may have about the risks and benefits of the test.

Non-Hodgkin's lymphoma (NHL) is a type of cancer that affects the lymphatic system, which is responsible for fighting infections and diseases in the body. NHL is a diverse group of cancers and its diagnosis and treatment depend on the type, stage and location of the disease. Positron emission tomography (PET) is a medical imaging technique that can be used to aid in the diagnosis and management of NHL. PET is a nuclear medicine imaging test that uses a small amount of a radioactive tracer, usually a form of glucose called fluorodeoxyglucose (FDG), to produce detailed images of the body's organs and tissues. FDG is injected into a vein in the arm and is absorbed by cells in the body that use glucose for energy. Cancer cells, which typically have a higher metabolic rate than normal cells, absorb more FDG than surrounding tissue and show up as bright spots on the PET scan.

Discussion

PET scans can be used to diagnose NHL by detecting abnormal areas of increased FDG uptake in lymph nodes or other organs. PET scans can also be used to stage NHL, or determine the extent of the disease in the body, by identifying areas of involvement beyond the lymph nodes. In addition, PET scans can be used to monitor the response to treatment, as the degree of FDG uptake in cancer cells can indicate whether the cancer is responding to treatment or not. One of the advantages of PET scanning is that it can provide a more accurate assessment of the extent of NHL than traditional imaging tests, such as CT or MRI. PET scanning can also be used to detect NHL recurrence earlier than traditional imaging tests, which may result in earlier treatment and better outcomes for patients.

However, PET scanning is not without limitations. PET scans can produce false-positive results, meaning that areas of increased FDG uptake may not necessarily indicate the presence of NHL. In addition, PET scanning can produce false-negative results, meaning that areas of NHL involvement may not show up on the scan. Therefore, PET scanning is usually used in combination with other imaging tests and diagnostic tools to ensure accurate diagnosis and staging of NHL. PET scanning is a valuable tool for the diagnosis and management of NHL. PET scanning can help identify areas of NHL involvement, stage the disease and monitor the response to treatment. Patients with NHL should discuss the risks and benefits of PET scanning with their healthcare provider and work together to determine the most appropriate diagnostic and treatment plan for their individual needs.

The study, published in the journal Radiotherapy and Oncology, analyzed data from 70 patients with DLBCL who had positive FDG-PET or gallium-67 scans after receiving chemotherapy. The patients received radiation therapy to target the residual cancerous tissue in the body. The researchers then evaluated the response of the residual disease to radiation therapy and its impact on the patients' overall survival. The results of the study showed that radiation therapy was effective in controlling the residual disease in patients with DLBCL who had positive post-chemotherapy FDG-PET or gallium-67 scans. Of the 70 patients in the study, 56 (80%) had a complete response to radiation therapy, meaning that there was no evidence of active cancer remaining in their bodies [1-6].

Conclusion

The median overall survival for the patients was 36 months and the three- year overall survival rate was 55%. The study also found that the location of the residual disease impacted the response to radiation therapy. Patients with residual disease in the central nervous system had a lower response rate to radiation therapy compared to patients with residual disease outside of the central nervous system. These findings suggest that radiation therapy may be an effective treatment option for patients with DLBCL who have positive post-chemotherapy FDG-PET or gallium-67 scans. However, more research is needed to determine the optimal dosage and timing of radiation therapy in these cases, as well as the long-term effects on patient outcomes. This study provides important insights into the use of radiation therapy in patients with DLBCL who have positive post-chemotherapy FDG-PET or gallium-67 scans. Radiation therapy was found to be effective in controlling residual disease in these patients, but further research is needed to determine the optimal use of this treatment modality.

Acknowledgment

None.

Conflict of Interest

None.

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