Role of radiation therapy in management of adult leukemia.

There are both defined and evolving roles for radiation therapy in the management of adult leukemias. For the acute leukemias, emphasis presently is on adjuvant irradiation of local manifestations including CNS "prophylaxis" for subclinical meningeal involvement. In chronic myelocytic leukemia, local palliative radiotherapy is complemented by the use of splenic irradiation for its systemic effect. Recently, total body irradiation has been shown to influence the natural history of chronic lymphocytic leukemia. For the first time, it has been possible to achieve remissions that prolong survival as well as improve the quality of life. Future exploitation or radiotherapy in adults with leukemia will be dependent upon improved communication and cooperation between the various medical specialists concerned with patient care in these diseases.