Modern radiotherapy in Hodgkin's lymphoma

The treatment of mostly young patients with Hodgkin lymphoma (HL) in most cases leads to a permanent cure. Unlike no other disease, the continuous treatment of patients in clinical trials led to an ongoing optimization of therapy. The initial large field radiotherapy was reduced as well as the irradiation dosage and by the addition of chemotherapy the combined modality was established. A selective review of the available data on HL and radiotherapy was carried out based on the PubMed database. Current technical innovations and new target volume definitions strongly influence radiotherapy planning and execution more than ever. Due to the excellent prognosis of HL patients, long-term toxicity plays a pivotal role. Lung fibroses, cardiac infarction and secondary malignancies are possible side effects. Their risk can be influenced by a thorough radiotherapy planning and execution. Thus, techniques, such as deep inspiration breath hold (DIBH) and modern radiotherapy techniques, such as intensity modulated radiotherapy (IMRT) and image guided radiotherapy (IGRT) have a strong impact, very similar to the new target volume definitions of the International Lymphoma Radiation Oncology Group (ILROG). The use of improved techniques in radiotherapy planning and performance has made high precision radiotherapy feasible. Furthermore, current data suggest a positive influence on acute and long-term side effects.