This review discusses the use of radiation therapy (RT) in the management of extranodal marginal zone lymphomas of mucosa-associated lymphoid tissues, also known as MALT lymphomas. Most patients with MALT lymphoma (~70%) present with stage I or II disease. The use of definitive moderatedose RT (24-30 Gy) for these patients with localized disease results in a high rate of durable local control and often cure. Effective use of RT is frequently possible, with minimal short-and long-term toxicity,

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... or both common and rare presentations of the disease. Emerging evidence also suggest an ultra-low dose regimen of 4 Gy in 2 fractions is useful as an initial approach for some sensitive anatomic sites. For patients with relapses of MALT lymphoma, the biologic behavior is often indolent, with slow growth and a tendency to relapse in other extranodal issues. Palliative RT is often the treatment of choice, as MALT lymphomas are exquisitely radiation sensitive. Similarly, for patients with stage III or IV disease and localized symptoms, ultra-low dose RT is often a good alternative to systemic therapy as it is very well tolerated in virtually any anatomic site in the body and has no significant toxicity.