Therapy for lymph node cancer | Lymph node cancer

Therapy for lymph node cancer

The goal, both in Hodgkin’s disease treatment and in the treatment of non-Hodgkin’s lymphomas, is to cure or contain the disease in all four stages described above. In general, chemotherapy and radiotherapy are available as forms of therapy, whereby radiotherapy is usually administered after chemotherapy. In stage 1 and 2 of the Ann-Arbor classification, two cycles of chemotherapy are initially administered, which is usually a combination of several chemotherapeutic agents (ABVD: Adriamycin, Bleomycin, Vinblastine, Dacarbazin).

This is followed by a so-called involute field irradiation, an irradiation strictly limited to the affected region in order to spare the surrounding healthy tissue. In stage 3 and 4, 8 cycles of extended chemotherapy are usually performed (combined chemotherapeutic agents: bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, prednisolone (BEACOPP)), which is subsequently also supplemented by involute field irradiation if residual tumor tissue can still be detected after chemotherapy. The therapy of non-Hodgkin’s lymphomas depends on the degree of malignancy.

Strongly malignant non-Hodgkin lymphomas generally respond well to chemotherapy, regardless of stage (CHOP therapy regimen: cyclophosphamide, hydroxydaunorubicin, oncovin (vincristine), prednisolone). If residual tumor tissue is detected, additional irradiation is also performed. Non-Hodgkin lymphomas, which are less malignant, respond very poorly to chemotherapy because of their slow growth. In stage 1 and 2 – with the prospect of a cure – they are only irradiated alone or in some cases even left untreated under observation. In stages 3 and 4, a cure is usually no longer possible, but chemotherapy according to the CHOP regimen is still attempted in cases of severe symptoms.

Prognosis and course of lymph node cancer

The prognosis of Hodgkin’s lymphoma differs significantly from that of non-Hodgkin’s lymphoma. However, the prognosis in both cases depends on the existing stage and the time when the appropriate therapy is initiated.Due to the expansion and improvement of therapy in recent years, the prognosis of existing lymph node cancer has also improved considerably, so that the chances of cure are good in many cases. The so-called 5-year survival rate for Hodgkin’s disease is currently around 80-90%, which means that 80-90% of affected patients are still alive after 5 years.

The fact that the 5-year survival rate is above 90% in the early stages of the disease, but still 80% in the advanced stages, shows that Hodgkin’s disease has a good chance of cure even in the later stages of the disease. However, the recurrence rate is relatively high, i.e. the probability that Hodgkin’s disease will recur after a certain period of time. There is also a 10-20% probability of suffering a second, different type of cancer as a result of the lengthy chemo- and radiotherapy.

For non-Hodgkin’s lymphomas, the prognosis also depends to a large extent on the degree of malignancy. Non-Hodgkin’s lymphoma types, which tend to be less malignant and preferably occur at an advanced age, are difficult or impossible to cure, but can usually be well controlled due to their slow growth over a period of up to 10 years. Non-Hodgkin’s lymphoma types that are highly malignant, on the other hand, have a long-term cure rate of up to 50-60% if treated appropriately (but if left untreated, they lead very quickly to death).