Whole abdominal irradiation in non-Hodgkin's lymphomas. II. Therapeutic criteria.

Three hundred ninety-one patients treated for non-Hodgkin's lymphoma from 1966 until 1983 were reviewed to discover a subset of 29 patients for whom whole abdominal radiation was the common modality of treatment. Seventeen patients were studied with staging laparotomy. the remainder by biopsy. Histologic characteristics revealed a diffuse-type pathology in 15 patients and a nodular-type in 14. Patients were further subselected into "favorable" (DWDLL, NPDLL, NML) and "unfavorable" (DULL, DML, DHL, DPDLL) histologies. Radical treatment for this series included 19 patients given a combined radio-chemotherapy program and 10 patients more conservatively treated with radiation alone. Follow-up for 16 living patients ranges from 2 to 16 years. Three patients developed secondary solid tumors and four patients died of intercurrent disease free from lymphoma. The possible role of whole abdominal radiation as definitive or adjunctive therapy is discussed.