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[The role of radiotherapy in chemoradiation treatment for nodal diffuse large B-cell non-Hodgkin lymphoma].

There is presented clinical observation of 125 patients with primary non-Hodgkin lymphomas stage I-IV (90 patients with diffuse large B-cell and 35 patients with primary mediastinal large B-cell lymphoma) treated with chemoradiotherapy. Radiotherapy was carried out in condition of conventional (60 patients) or multifractionation (65 patients). 75 (60.0%) patients underwent positron emission tomography with 18F-FDG of the whole body (130) in different periods of the clinical course of the disease. In addition patients with diffuse large B-cell lymphoma were monitored by main indicators of peripheral blood before and at different stages of treatment. It was found that after a period of drug treatment radiotherapy increased the frequency of complete remissions in patients with diffuse large B-cell and primary mediastinal large B-cell lymphoma by 24.4% and 44.2%, respectively, contributing to satisfactory long-term results. Fractionation regime did not significantly affect the results of treatment but radiation pneumonitis was observed only in the normal dose fractionation. Positron emission tomography with 18F-FDG in this category of patients was of great importance specifying the spread of the tumor. The frequency of complete metabolic response significantly increased after radiotherapy compared to drug treatment stage. Reduction of hematological parameters after radiotherapy in patients with diffuse large B-cell lymphoma was mostly of I-II degree and did not interfere with treatment. Leukopenia, neutropenia and thrombocytopenia were more significant when irradiation was performed two times a day compared to those in condition of conventional fractionation.