Do you offer adjuvant chemoimmunotherapy after IFRT for Stage I to II low grade follicular lymphoma?

I do not. Absent overall survival benefit, which is not seen or reported, this strategy overtreats the subset of patients who are cured with RT alone, and prematurely exposes the other group to the toxicity of chemotherapy.

The most recent data that utilize rituximab-containing systemic therapy (CVP) after definitive IFRT come from MacManus et al. (Randomized Trial of Systemic Therapy After IFRT in Patients with Early-Stage Follicular Lymphoma: TROG 99.03. JCO. 2018 36:29, 2918-2925). Ten-year PFS rates were 59% (95% C...