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Sep 29
Education

EDU 49 - Beyond the Nodes: A Practical Guide to Extranodal Lymphomas

03:45pm - 05:00pm ET
Hematologic Malignancies

MODERATOR(S)

George Mikhaeel, MD, MBBS - Guy's and St. Thomas' NHS Foundation Trust

session DESCRIPTION

Extranodal lymphoma radiotherapy varies widely based on anatomic site, histology and systemic therapy context. The introductory talk will provide a clear, high-level overview of extranodal lymphomas, focusing on common clinical scenarios radiation oncologists encounter in practice. It will review how radiotherapy dose and field design have evolved over time and how treatment approaches differ between more frequent presentations (such as orbit and gastric lymphoma) and higher-risk or immune-privileged sites, setting a practical framework for clinical decision making. Breast lymphoma, while uncommon, presents real-world challenges in determining how to deliver radiotherapy. The second talk will review typical presentations and patterns of relapse, summarize the evidence supporting radiotherapy in breast lymphoma, and provide practical guidance on dose selection, target volumes and coordination with systemic therapy. Emphasis will be placed on applying available data to everyday practice while minimizing toxicity and unnecessary treatment. Testicular lymphoma is a classic sanctuary-site disease in which radiotherapy remains a key component of care, yet questions persist regarding set-up, planning and integration with systemic and CNS-directed therapy. Radiotherapy effects on testosterone levels and monitoring guidance will be provided. The final talk will translate foundational evidence into actionable recommendations, highlighting common pitfalls and best practices that radiation oncologists can readily implement across practice settings. Together, these talks aim to reduce practice variability by offering a straightforward, evidence-based approach to extranodal lymphomas, providing attendees with practical tools they can apply immediately while also contextualizing ongoing areas of uncertainty and evolution in the field.

learning objectives

  1. Describe the spectrum of extranodal lymphomas and the evolution of radiotherapy dose and field design across indolent, aggressive and immune-privileged sites - highlighting how biology, anatomic site (e.g., orbit, stomach, CNS) and systemic therapy integration inform contemporary treatment selection and set the framework for site-specific management.
  2. To differentiate between the clinical presentations and management options for common histological subtypes of primary breast lymphoma and recognize the different management of breast transplant related lymphomas.
  3. Explain the rationale, indications and technical considerations for testicular radiotherapy in testicular lymphoma, including patterns of failure, dose selection and integration with systemic and CNS-directed therapy.

Credits

AMA PRA Category 1 Credits: 1.00

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