Radiation therapy

Limited-field radiation therapy is the most-common treatment approach for patients with early-stage disease. This histology is rare, but this approach is based on retrospective analysis spanning several decades.[5,11-15]

Patients with nonbulky lymphocyte–predominant disease presenting in unilateral high neck (above the thyroid notch) or epitrochlear locations require only involved-field radiation therapy (IFRT) after clinical staging.[16] A retrospective report of 426 cases of lymphocyte-predominant HL (including the nodular lymphocyte–predominant and lymphocyte-rich classic subtypes) showed that more patients died of acute and long-term treatment-related toxicity than of recurrent HL.[3][Level of evidence C1] Limitation of radiation dose and radiation fields and avoidance of leukemogenic chemotherapeutic agents, along with watchful waiting policies, should be investigated for these subgroups.[15,17]