Computed Tomography Role In Limited-Stage Lymphomas: Could We Reduce The Dose Of Radiation?

Lymphomas are the most frequent blood cancer. Current Lymphoma’s guidelines recommend initial staging and interim surveillance computed tomography (CT) scan, repeated every 6-12 mo for the first 2 years (ys) after end of treatment. Recent studies show that patients receiving 8 or more CTs have a 2-fold increase in secondary malignancies. This risk is dose-dependent. Cumulative exposure in excess of 75mSv has been estimated to increase cancer mortality by 7.3%. At present, more than 80% Hodgkin’s Lymphoma (HL) patients and more than 60% of NHL patients will be alive 5 ys after diagnosis. This percentage is higher in early stage disease (HL: 96 % overall survival (OS) at 5 ys; NHL: depends on the subtype, for DLBCL: 68-90 % at 5 ys). Considering this high survival rates and the demonstrated toxicity of radiation, avoiding CT scans overuse seems reasonable, especially in those with great chances of being cured.