The Department of Radiation Oncology at Cleveland Clinic is also at the cutting edge of research in pioneering the use of several specialized lymphoma radiotherapy treatment techniques. For certain types of indolent lymphomas, the use of radio-labeled antibodies as a form of experimental "systemic radiotherapy" is under evaluation. Several different antibodies bound to several different isotopes have been used in clinical trials at Cleveland Clinic.
The advantage of this approach, as opposed to the brachytherapy programs, is that the "targeted radiotherapy" can be injected into the circulation and allowed to localize simultaneously in many different sites of disease involvement. Although the exact level of clinical effectiveness for this sort of radiotherapy treatment will vary depending on the case, 50% or more of patients who receive this sort of radiotherapy treatment will demonstrate a good clinical response even for fairly advanced cases. It is expected that FDA clearance will be granted soon for one or more of these agents.
Another specialized technology in common use at Cleveland Clinic is total body radiation. This radiotherapy treatment is often given in the context of a bone marrow transplant, and in the past it has generally involved very high doses of radiation given over a period of days just prior to the infusion of the transplanted bone marrow or blood stem cells. More recently, there has been a high level of interest in the use of so-called "minitransplants" which utilize low dose total body radiation to prepare patients for infusion of a donor stem cells.
This radiotherapy approach is based on the desire to use the donor stem cells as a trigger mechanism to promote an immunologic attack on the cancer cell population, or as a way to provide a temporary "bridge" for patients whose bone marrow is rejecting a transplanted organ. For these "mini-transplants", the usual dose of radiation is about one-sixth of the dose typically used for conventional bone marrow transplants. The side effects and risks of the total body radiation are therefore much less than one sees in the conventional bone marrow transplants brachytherapy programs.
