Total body irradiation in non-Hodgkin's lymphoma.

Between October 1972 and August 1977, low-dose fractionated total body irradiation (TBI), 150–300 rad, was selected for 48 patients with previously untreated non-Hodgkin's lymphoma staged II, III and IV. In 63% of the patients the disease had a nodular pattern; there were no patients with diffuse histiocytic lymphoma.All but 2 patients responded to TBI. The 4-year actuarial survival was 71% for the nodular group and 57% for the diffuse group.There were no acute symptoms during the course of treatment and no mortality associated with the treatment. Seventeen per cent of the patients developed transient platelet counts less than 30,000/mm³. Four required hospitalization for correction of thrombocytopenia and/or infection.The majority of patients who failed more than 3 months after initial complete remission were placed back in remission with either chemotherapy, TBI, or local irradiation. Patients with persistent disease after TBI showed a less favorable response with chemotherapy.A selected group of 15 patients in relapse after chemotherapy or localized radiotherapy were treated with TBI. Eleven responded to treatment, while 4 showed no useful response. The median survival for this group was slightly over 2 years. Twenty per cent developed transient platelet counts less than 30,000/mm³.