Various treatment options are available for the management of Non-Hodgkin’s Lymphoma (NHL) and most of them are directed towards the cure of the disease. Various methods include chemotherapy that involves treatment by drugs, radiotherapy involving treatment with radiation, surgery wherein surgical removal of the affected tissue is done, immunotherapy where the immune system of the body is boosted by immunomodulating drugs and the steroidal therapy.
What Is The Best Treatment For Non-Hodgkin’s Lymphoma?
Chemotherapy is by far the best treatment for managing non-hodgkin’s Lymphoma. This treatment is the mainstay of treatment and is combined with other second line treatment such as radiotherapy, steroidal drugs or immunotherapy. There are many drugs available in chemotherapy having their own side effects. The chemotherapy is done with the combination of drugs so as to combine their efficacy and reducing the side effects. Further, different combinations of drugs are used for different typed of Non-Hodgkin’s Lymphoma on the basis of location and subtypes. The treatment is also decided on the basis of stage of Non-Hodgkin’s Lymphoma and the response of patient to a particular combination. Following are the types of chemotherapy combinations generally used in the treatment of lymphoma:
R-CHOP: The drug includes in this strategy are rituximab with cyclophosphamide, doxorubicin, Oncovin® (vincristine), and prednisone. It is generally given with the goal to cure lymphoma and it works by shrinking the T-cell lymphoma.
DHAP: The drugs include in this strategy are Dexamethasone, high-dose cytarabine, and cisplatin.
F-CVP: The drugs of this strategy are fludarabine with cyclophosphamide, vincristine, and prednisone.
B-R: The B-R combination includes Bendamustine and rituximab.
Rituximab-HyperCVAD: Rituximab, cyclophosphamide, vincristine, Adriamycin® (doxorubicin), dexamethasone, to be kept in alternating with R-MC: Rituximab, methotrexate-cytarabine
Treatment For Non-Hodgkin’s Lymphoma
The treatment strategy of the Non-Hodgkin’s Lymphoma depends upon the stage of the disease and the subtypes of Non-Hodgkin’s Lymphoma. The Non-Hodgkin’s Lymphoma subtypes are divided in to one that requires aggressive treatment and the other which is indolent, requiring a “wait and watch” strategy. Generally, the treatment is done by combining various treatment options simultaneously so as to provide maximum efficacy with minimum side effects. Following are the treatment options available to the oncologists for the management of lymphoma:
- Chemotherapy: This treatment is by far the best and most important treatment of cancer. This is the primary treatment around which the other treatment revolves. This has the advantage of killing the cancerous cells in systemic circulation along with the localized action. Various drugs are available, and the treatment is generally done with the combination of chemotherapeutic agents. The drugs generally used for treating NHL are bendamustine, carmustine, gemcitabine and methotrexate.
- Radiotherapy: When the lymphoma is present only at the localized region, radiotherapy can be advised by the doctor. The strategy is to combine both chemotherapy and radiotherapy so as to treat the cancer as early as possible with reduced side effects.
- Antitumor Antibiotics: Various antitumor antibiotics are used for the treatment of Non-Hodgkin’s Lymphoma. These drugs include doxorubicin and mitoxantrone.
- Steroids: Various steroidal drugs are used as a treatment options for destroying the cancerous cells. They are generally used with the chemotherapy to reduce the side effects of chemotherapy. The steroids used in this indication are dexamethasone, prednisone and methylprednisolone.
- Immunotherapy: Various immunomodulating agents are available for treating lymphoma. These immunomodulating agents perform dual function. First, they activate the immune system of the body to fight against cancer cells and second, they also interact and kill the cancer cells. The drugs used in the immunotherapy are rituximab and yttrium-90‑ibritumomab tiuxetan.
- Surgery: Sometimes the surgical intervention is required to remove the affected tissue or organ.
The treatment options for Non-Hodgkin’s Lymphoma available to oncologists have their own advantages and disadvantages. The strategy is decided on the basis of various parameters and the goal is to increase the efficacy of the treatment with least side effects. However, chemotherapy is the most frequently used and most effective treatment for Non-Hodgkin’s Lymphoma. Various drug combinations are administered depending upon the stage and type of Non-Hodgkin’s Lymphoma.