Modern Radiotherapy for the Treatment of Lymphoma and Myeloma: Integration with Systemic Treatment and Advanced Imaging Techniques

A special issue of Hematology Reports (ISSN 2038-8330).

Deadline for manuscript submissions: 20 July 2025 | Viewed by 753

Special Issue Editors


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Guest Editor
Department of Radiation Oncology ASST Spedali Civili di Brescia, Brescia University, 25123 Brescia, Italy
Interests: radiotherapy; radiation oncology; lymphomas; multiple myeloma

E-Mail Website
Guest Editor
Department of Radiation Oncology ASST Spedali Civili di Brescia, Brescia University, 25123 Brescia, Italy
Interests: radiotherapy; radiation oncology; lymphomas; multiple myeloma
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Special Issue Information

Dear Colleagues,

The landscape of lymphoma treatment is continuously evolving due to relentless advancements and innovations. Among the cornerstone treatment modalities, radiation therapy has undergone significant transformations in its role and application. This Special Issue aims to provide a comprehensive overview of the current state of radiotherapy for the treatment of lymphoma, highlighting its evolving role, challenges and advantages in the context of modern oncology.

Radiotherapy, as a cornerstone of lymphoma therapy, has undergone significant transformations, driven by advancements in technology, treatment strategies and imaging modalities.

A wide range of innovative systemic treatments have been approved in last years, reshaping the role of radiotherapy (e.g., in combination with immunotherapy or as a bridging strategy for CAR-T). Nonetheless, multiple issues still need to be clarified, such as the optimal timing to augment effectiveness and reduce the risk of increased toxicity.

Radiation therapy itself underwent a radical evolution following the adoption of conformal techniques (such as IMRT and VMAT) and improvement in treatment delivery through image-guided radiation therapy (IGRT) and breath control techniques. Moreover, the integration of advanced imaging modalities such as magnetic resonance imaging (MRI) and nuclear medicine studies improved the ability to accurately identify the target volumes and organs at risk. The implementation of these strategies allows for providing adequate target coverage while sparing the surrounding healthy tissues.

This Special Issue serves as a comprehensive resource for clinicians, researchers and healthcare professionals involved in the management of lymphoma. Through a series of articles and reviews, it addresses the current challenges, advancements and future directions in radiotherapy for lymphoma treatment.

Dr. Andrea Guerini
Prof. Dr. Michela Buglione Di Monale E Bastia
Guest Editors

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Keywords

  • radiotherapy lymphoma
  • myeloma
  • imaging
  • systemic treatment

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Published Papers (1 paper)

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Research

10 pages, 966 KiB  
Article
Treatment of Non-Hodgkin Lymphoma Involving Head and Neck Sites with a 1.5 T MR-Linac: Preliminary Results from a Prospective Observational Study
by Andrea Emanuele Guerini, Stefania Nici, Stefano Riga, Ludovica Pegurri, Paolo Borghetti, Eneida Mataj, Jacopo Balduzzi, Mirsada Katica, Gianluca Cossali, Giorgio Facheris, Luca Triggiani, Albert Sakiri, Luigi Spiazzi, Stefano Maria Magrini and Michela Buglione
Hematol. Rep. 2025, 17(2), 16; https://doi.org/10.3390/hematolrep17020016 - 27 Mar 2025
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Abstract
Purpose: Lymphomas are generally radiosensitive; therefore, disease volume tends to shrink during radiotherapy courses. As MRI-linac provides excellent soft tissue definition and allows daily re-contouring of gross tumor volume and clinical target volume, its adoption could be beneficial for the treatment of [...] Read more.
Purpose: Lymphomas are generally radiosensitive; therefore, disease volume tends to shrink during radiotherapy courses. As MRI-linac provides excellent soft tissue definition and allows daily re-contouring of gross tumor volume and clinical target volume, its adoption could be beneficial for the treatment of lymphomas. Nonetheless, at this time there is a lack of literature regarding the use of MR-linac in this context. Methods: A prospective observational study was conducted on patients affected by non-Hodgkin lymphoma (NHL) involving head and neck (H&N) sites and treated with Elekta Unity® MR-Linac. The clinical and dosimetric data of the first eight patients were collected and integrated with relevant data from medical records. Results: Seven patients had B-cell lymphoma (three DLBCL, two MALT, one follicular, and one mantle-cell) and one T-cell/NK lymphoma. The intent of RT was radical for four patients, salvage treatment for three, and CAR-T bridging for one. Two patients presented orbital localizations and six cervical lymphonodal sites. Median GTV was 5.74 cc, median CTV 127.01 cc, and median PTV 210.37 cc. The prescribed dose was 24–50 Gy in 2 Gy fractions for seven patients and 24 Gy in 3 Gy fractions for one patient. All the patients experienced acute toxicity, the maximum grade was G1 for five patients and G2 for three at the end of RT. One month after radiotherapy seven patients still experienced G1 toxicity, but no toxicity grade ≥ 2 was reported. First radiological assessment was performed for all the patients after a median of 101.5 days, reporting complete response in all the cases. After a median follow up of 330 days, no patient experienced local disease progression, while one patient developed distant progression. Conclusions: radiotherapy for NHL with H&N localization using a 1.5 T MR-linac was feasible, with no >G2 toxicity and optimal response rate and disease control. Full article
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