Author/Editor     Juretić, Antonio; Živković, Mirko; Gamulin, Marija; Herceg, Tonko; Bagović, Davorin; Kučan, Damir; Zeljko, Žarko; Ajduković, Radmila
Title     Radiotherapy for stage IAE non-Hodgkin's lymphoma of the testicle - a case report
Translated title     Radioterapija pri bolniku z ne-Hodgkinovim limfomom testisa, stadij IAE - prikaz primera
Type     članek
Source     Radiol Oncol
Vol. and No.     Letnik 37, št. 3
Publication year     2003
Volume     str. 175-81
Language     eng
Abstract     Background. The aim of this report is to present the irradiation technique applied to a patient with primary testicular non-Hodgkin's (NHL) lymphoma stage IEA, histologically CD20 positive NHL - diffuse follicular center cell (FCC) lymphoma grade HL Since primary NHLs of the testis are rather rare, no uniform radiotherapy approach to their treatment has been developed to date. Testicular NHLs are relatively often of aggressive biological characterisiics, so that the disease relapse is not uncommon even in patients in an early stage of the disease (stage 1 and 11), who received seemingly optimal therapy (orchiectomy of the diseased testicle, polychemotherapy and irradiation). Case report. In this report the applied radiation treatment field is shown. The disease was diagnosed in June 2001 after the inguinal orchiectomy. Afterwards, the patient received 6 courses of polychemotherapy (CHOP) plus intrathecal methotrexate therapy. The irradiation was conducted with one direct 6 megavolt (MV) energy photon beam. The irradiation field encompassed the contralateral testicle (scrotum) and inguino femoral lymph nodes. The radiotherapy dose was 30 Gy applied in 15 fractions calculated at the depth of 4 cm. The radiotherapy finished in December 2001. The patient has regular check-ups (last in May 2003) and has been in remission since then. Conclusions. Relapse sites are quite often extranodal, not in the regional lymph nodes. Therefore, considering the radiation treatment fields there are no definitive recommendations.
Summary     Izhodišča. Namen članka je opisati obsevalno tehniko pri bolniku, ki smo ga zdravili zaradi primarnega ne-Hodgkinoveha limfoma (NHL) testisa, stadij IEA. Histološki izvid je pokazal, da je imel bolnik CD20 pozitiven NHL, oz. difuzno folikularen centrocitni (FCC) limfom, gradus III. Ker so primarni NHL-i redki, do sedaj ni bilo izdelanih splošno sprejetih načel, kako takšne bolnike obsevati. Bolezen NHL testisa poteka sorazmerno agresivno, zato so ponovitve bolezni pogoste tudi pri bolnikih, ki imajo zgodnji stadij bolezni (stadij I in II), in so bili po dosedanjih načelih optimalno zdravljeni (z orhiektomijo, polikemoterapijo in obsevanjem). Prikaz primera. Bolniku smo ugotovili natančno diagnozo junija 2001, ko je bila narejena orhiektomija. Nato je prejel 6 krogov polikemoterapije (CHOP) in tudi intratekalno kemoterapijo z metotreksatom. Sledilo je obsevanje z enim direktnim poljem in z energijo 6 megavoltov na linearnem pospeševalniku. Obsevalno polje je obsegalo kontralateralni testis (skrotum) in ingvinofemoralne limfne bezgavke. Obsevalna doza je bila 30 Gy, ki smo jo aplicirali s 15 frakcijami in je bila določena na globini 4 cm. Zdravljenje z obsevanjem smo končali decembra 2001. Bolnika smo redno kontrolirali, tudi ob zadnjem pregledu maja 2003 je bil brez znakov bolezni. Zaključki. Ker je ponovitev bolezni pri NHL testisov pogosta ekstranodalno ne pa v predelih limfnih bezgavk, ne moremo dokončno priporočiti, katere predele naj pri bolniku obsevamo.
Descriptors     TESTICULAR NEOPLASMS
LYMPHOMA, NON-HODGKIN'S
AGED
NEOPLASM STAGING
ORCHIECTOMY
TREATMENT OUTCOME