Patients with the following diagnoses may benefit from radiation therapy:

• localised disease
• advanced disease with a dominant bulky lesion.

Radiation therapy is usually used in conjunction with chemotherapy to treat patients with Hodgkin lymphoma or DLBCL. These considerations should be part of the multidisciplinary team planning.

Timeframes for starting treatment

Treatment should begin within two weeks of diagnosis and staging, unless the patient wants to delay treatment (e.g. to pursue fertility preservation measures).

In cases with critical organ compromise or rapid clinical progression, it may be necessary to start treatment within 24 hours of diagnosis.

Training and experience required of the appropriate specialists

Fellow of the Royal Australian and New Zealand College of Radiologists or equivalent, with adequate training and experience, institutional credentialing and agreed scope of practice in Hodgkin lymphoma or DLBCL.

The training and experience of the radiation oncologist should be documented.

Health service unit characteristics

To provide safe and quality care for patients having radiation therapy, health services should have these features:

• staff familiar with lymphoma-specific radiation therapy techniques
• access to PET-CT and electronic transfer of PET-CT data for planning
• linear accelerator (LINAC) capable of image-guided radiation therapy (IGRT)
• dedicated CT planning
• access to MRI and PET imaging
• automatic record-verify of all radiation treatments delivered
• a treatment planning system
• trained medical physicists, radiation therapists and nurses with radiation therapy experience
• access to allied health, especially nutrition health and advice
• coordination for combined therapy with systemic therapy, especially where facilities are not co-located
• participation in Australian Clinical Dosimetry Service audits
• an incident management system linked with a quality management system.