Extended-field radiation therapy (EFRT) is a term used for delivering radiation to large areas of the body in certain types of lymphoma, notably Hodgkin lymphoma.
It involves the treatment of affected lymph node regions as well as other regions of the body where lymph nodes may soon get affected. Typically, if it only involves lymph nodes in the neck, radiation will be delivered to both sides of the neck, both armpits, and the mediastinum (the central part of the chest).
This kind of treatment is used when radiotherapy is the only treatment, without the addition of chemotherapy or biological agents. Here, radiation must be targeted not only to those areas where tumor is obviously present, but also to areas where a few tumor cells may have spread but are not visible during examination or in scans.
The most common use of EFRT is in early stage Hodgkin lymphoma. See Understanding Lymphoma Stages for more on lymphoma staging. The terms ‘mantle field,’ ‘inverted Y field,’ ‘para-aortic and splenic field’ refer to radiation treatment of different areas of the body.
With the increasing use of multimodality treatments (combining chemotherapy and radiation), the use of EFRT has reduced. EFRT techniques are now limited to patients with early stage Hodgkin lymphoma who do not have any bad prognostic factors. If the prognosis is poor, chemotherapy and involved-field radiation is considered a better treatment option.
