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How would you treat a stage I peripheral <3cm extranodal marginal zone lymphoma of the lung? Is SBRT appropriate? If so, what dose would you use?

1 Answer
Mednet MemberInvited Expert
Radiation Oncology · Duke University Medical Center
Answered on

Marginal zone lymphoma of the lung is a very uncommon variant of MZL but appears to have the same favorable outlook as MZL in other locations. Standard dose for localized MZL is 24-30 gy (2gy per fraction) with lower doses generally used in the eye with local control exceeding 90%. Investigations are underway to see if even lesser doses will suffice, e.g. 2 gy x2, but that is not currently standard when curative therapy is being prescribed. I see no indication for SBRT. I would probably Rx with 24gy with few fields (depending on exact tumor location) to avoid giving large volumes of lung a small RT dose.