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Non-Hodgkin's Lymphoma - Staging and Treatment Guidelines
(Page 2)
- Radiation therapy. Radiation to local areas can achieve a cure in 40 - 50% of patients.
- Chemotherapy. Chemotherapy uses drugs to kill cancer cells.
- Watchful waiting. Patients who choose watchful waiting must be aware of signs and conditions indicating the need for treatment. These include B symptoms, endangered organs, massive bulky tumors, or a steady progression that lasts at least 6 months.
- Investigative treatments such conjugated and unconjugated monoclonal antibodies or radiation plus chemotherapy. In one study, a combination of therapies worked better than radiation alone.
The following are treatment options for some specific low-grade lymphomas:
- Mucosa-associated lymphoid tissue (MALT) lymphoma. When disease is in the stomach (gastric MALT) and the patient is infected with H. pylori bacteria, antibiotics can cause regression in a significant number of patients with stage I lymphoma. In certain patients where antibiotics fail, or are not appropriate, radiation alone can achieve significant cure rates. Surgery with or without radiation, or chemotherapy with or without radiation are possible options. Treatment options for patients with MALT localized in other sites depend on the location of the specific disease, ranging from radiation to chemotherapy to biologic therapies, such as interferon.
- Primary gastric lymphoma (indolent). Radiation is the typical treatment for this lymphoma, which is located only in the stomach, small intestine, or other nearby regions. Surgery is being reconsidered since it seems to offer no advantage.
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Early Stage Aggressive (Intermediate- to High-Grade) Lymphomas. Treatment options include:
- Chemotherapy alone
- Combinations of chemotherapy (usually CHOP) plus radiation therapy
- Radiation alone (rarely)
- Chemotherapy alone or with surgery for lymphoma in the gastrointestinal region
- Immunotherapies (rituximab, Bexxar) with or without chemotherapy (usually CHOP), or high dose chemotherapy and bone marrow or stem cell transplantation
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