How would you define bulky involvement of the tonsil in a patient with DLBCL?
The patient in question has Stage IIIA DLBCL with a CR after 6 cycles R-CHOP. When would you treat the involved tonsil?
1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Duke University Medical Center
Answered on
While the definition of "bulky" disease has been relatively consistent in the Hodgkin literature, the definition in prospective DLBCL trials has not. For example...
ECOG 1484 - 10 cm
RICOVER-60 & RICOVER-noRTh - 7.5 cm
UNFOLDER - 7.5 cm
OPTIMAL>60 - 7.5 cm
Intergroup National Clinical Trials Network Study S1001 - 10 cm
LYSA/GOELAMS - 7 cm
PARMA (auto-tx study) - 5 cm
....just to name a few.
Whatever the definition, the use of "bulk" has largely been utilized to determine eligibility criteria, either to exclude all patients with bulky disease (GELA, LYSA/GOELAMS, S1001) or to restrict enrollment to more favorable patients with disease bulk (SWOG).
The RICOVER-60 & RICOVER-noRTh trials s...
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