Rotational Volume-Modulated Radiation Therapy of Unresectable Localised Form of Castleman's Disease

Rеlevance: Castleman’s disease is a relatively rare heterogeneous group of lymphoproliferative diseases, the incidence of the localized form is 15, and the multicentric form is about 5 people per 1 million population. Currently, surgical treatment is the most radical in the treatment of localized forms of Castleman’s disease, and in cases where the clinical situation is considered unresectable, the treatment strategy is not strictly defined. Studies of the effect of radiation therapy on the survival rates of patients with Castleman’s disease remain isolated to this day, up to the description of individual clinical cases. This is due to the low incidence of this pathology, which does not allow for high-power randomized clinical trials. However, empirical accumulation of experience suggests that conducting remote radiation therapy in total doses of 40 Gy helps to achieve long-term local control. The use of modern methods of radiation therapy in the form of volume-modulated radiation therapy makes it possible to avoid serious post-radiation damage to healthy organs and tissues adjacent to the tumor, and can help in achieving stable local control in the treatment of unrecoverable forms. It is possible to use DLT protocols used in the treatment of lymphomas, which may be comparable in their effectiveness for Castleman’s disease, which requires subsequent research.

Purpose: Аn analysis of a rare clinical observation of the successful use of rotational volume-modulated radiation therapy in the treatment of an unresectable localized form of Castleman’s disease.

Material and methods: The search and analysis of literature data in Russian and English for the period from 2000 to 2023 in the databases Medline/PubMed, RSCI/Elibrary, CyberLeninka, Google Scholar, devoted to the diagnosis and treatment of Castleman’s disease. Clinical observation of the use of rotational volume-modulated radiation therapy in the treatment of an unresectable localized form of Castleman’s disease with lesions of the supraclavicular lymph nodes (hyaline-vascular type, unicentric variant).

Results: Rotational volume-modulated radiation therapy of an unresectable localized form of Castleman’s disease can have a stable and safe consolidating effect in the form of long-term local control.